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Posted: December 22, 2016 at 1:17 pm
In dealing with an objection to the view of abortion presented in Chapter 6, we have already looked beyond abortion to infanticide. In so doing we will have confirmed the suspicion of supporters of the sanctity of human life that once abortion is accepted, euthanasia lurks around the next comer – and for them, euthanasia is an unequivocal evil. It has, they point out, been rejected by doctors since the fifth century B.C., when physicians first took the Oath of Hippocrates and swore ‘to give no deadly medicine to anyone if asked, nor suggest any such counsel’. Moreover, they argue, the Nazi extermination programme is a recent and terrible example of what can happen once we give the state the power to MI innocent human beings.
I do not deny that if one accepts abortion on the grounds provided in Chapter 6, the case for killing other human beings, in certain circumstances, is strong. As I shall try to show in this chapter, however, this is not something to be regarded with horror, and the use of the Nazi analogy is utterly misleading. On the contrary, once we abandon those doctrines about the sanctity of human life that – as we saw in Chapter 4 – collapse as soon as they are questioned, it is the refusal to accept killing that, in some cases, is horrific.
‘Euthanasia’ means, according to the dictionary, ‘a gentle and easy death’, but it is now used to refer to the killing of those who are incurably ill and in great pain or distress, for the sake of those killed, and in order to spare them further suffering or distress. This is the main topic of this chapter. I shall also consider, however, some cases in which, though killing is not contrary to the wishes of the human who is killed, it is also not carried out specifically for the sake of that being. As we shall see, some cases involving newborn infants fall into this category. Such cases may not be ‘euthanasia’ within the strict meaning of the term, but they can usefully be included within the same general discussion, as long as we are clear about the relevant differences.
Within the usual definition of euthanasia there are three different types, each of which raises distinctive ethical issues. it will help our discussion if we begin by setting out this threefold distinction and then assess the justifiability of each type.
TYPES OF EUTHANASIA
Most of the groups currently campaigning for changes in the law to allow euthanasia are campaigning for voluntary euthanasia – that is, euthanasia carried out at the request of the person killed.
Sometimes voluntary euthanasia is scarcely distinguishable from assisted suicide. In Jean’s Way, Derek Humphry has told how his wife Jean, when dying of cancer, asked him to provide her with the means to end her life swiftly and without pain. They had seen the situation coming and discussed it beforehand. Derek obtained some tablets and gave them to Jean, who took them and died soon afterwards.
Dr Jack Kevorkian, a Michigan pathologist, went one step further when he built a ‘suicide machine’ to help terminally ill people commit suicide. His machine consisted of a metal pole with three different bottles attached to a tube of the kind used to provide an intravenous drip. The doctor inserts the tube in the patient’s vein, but at this stage only a harmless saline solution can pass through it. The patient may then flip a switch, which will allow a coma-inducing drug to come through the tube; this is automatically followed by a lethal drug contained in the third bottle. Dr Kevorkian announced that he was pre- pared to make the machine available to any terminally ill patient who wished to use it. (Assisting suicide is not against the law in Michigan.) In June 1990, Janet Adkins, who was suffering from Alzheimer’s disease, but still competent to make the decision to end her life, contacted Dr Kevorkian and told him of her wish to die, rather than go through the slow and progressive deterioration that the disease involves. Dr Kevorkian was in attendance while she made use of his machine, and then re- ported Janet Adkins’s death to the police. He was subsequently charged with murder, but the judge refused to allow the charge to proceed to trial, on the grounds that Janet Adkins had caused her own death. The following year Dr Kevorkian made his device available to two other people, who used it in order to end their lives.
In other cases, people wanting to die may be unable to kill themselves. In 1973 George Zygmaniak was injured in a motorcycle accident near his home in New Jersey. He was taken to hospital, where he was found to be totally paralysed from the neck down. He was also in considerable pain. He told his doctor and his brother, Lester, that he did not want to live in this condition. He begged them both to kill him. Lester questioned the doctor and hospital staff about George’s prospects of recovery: he was told that they were nil. He then smuggled a gun into the hospital, and said to his brother: ‘I am here to end your pain, George. Is it all right with you?’ George, who was now unable to speak because of an operation to assist his breathing, nodded affirmatively. Lester shot him through the temple.
The Zygmaniak case appears to be a clear instance of voluntary euthanasia, although without some of the procedural safeguards that advocates of the legalisation of voluntary euthanasia propose. For instance, medical opinions about the patient’s prospects of recovery were obtained only in an informal manner. Nor was there a careful attempt to establish, before independent witnesses, that George’s desire for death was of a fixed and rational kind, based on the best available information about his situation. The killing was not carried out by a doctor. An injection would have been less distressing to others than shooting. But these choices were not open to Lester Zygrnaniak, for the law in New Jersey, as in most other places, regards mercy killing as murder, and if he had made his plans known, he would not have been able to carry them out.
Euthanasia can be voluntary even if a person is not able, as Jean Humphry, Janet Adkins, and George Zygmaniak were able, to indicate the wish to die right up to the moment the tablets are swallowed, the switch thrown, or the trigger pulled. A person may, while in good health, make a written request for euthanasia if, through accident or illness, she should come to be incapable of making or expressing a decision to die, in pain, or without the use of her mental faculties, and there is no reasonable hope of recovery. In killing a person who has made such a request, who has re-affirmed it from time to time, and who is now in one of the states described, one could truly claim to be acting with her consent.
There is now one country in which doctors can openly help their patients to die in a peaceful and dignified way. In the Netherlands, a series of court cases during the 1980s upheld a doctor’s right to assist a patient to die, even if that assistance amounted to giving the patient a lethal injection. Doctors in the Netherlands who comply with certain guidelines (which will be described later in this chapter) can now quite openly carry out euthanasia and can report this on the death certificate with- out fear of prosecution. It has been estimated that about 2,300 deaths each year result from euthanasia carried out in this way.
I shall regard euthanasia as involuntary when the person killed is capable of consenting to her own death, but does not do so, either because she is not asked, or because she is asked and chooses to go on living. Admittedly this definition lumps two different cases under one heading. There is a significant difference between killing someone who chooses to go on living and killing someone who has not consented to being killed, but if asked, would have consented. In practice, though, it is hard to imagine cases in which a person is capable of consenting and would have consented if asked, but was not asked. For why not ask? Only in the most bizarre situations could one conceive of a reason for not obtaining the consent of a person both able and willing to consent.
Killing someone who has not consented to being killed can properly be regarded as euthanasia only when the motive for killing is the desire to prevent unbearable suffering on the part of the person killed. It is, of course, odd that anyone acting from this motive should disregard the wishes of the person for whose sake the action is done. Genuine cases of involuntary euthanasia appear to be very rare.
These two definitions leave room for a third kind of euthanasia. If a human being is not capable of understanding the choice between life and death, euthanasia would be neither voluntary nor involuntary, but non-voluntary. Those unable to give con- sent would include incurably ill or severely disabled infants, and people who through accident, illness, or old age have permanently lost the capacity to understand the issue involved, with- out having previously requested or rejected euthanasia in these circumstances.
Several cases of non-voluntary euthanasia have reached the courts and the popular press. Here is one example. Louis Repouille had a son who was described as ‘incurably imbecile’, had been bed-ridden since infancy and blind for five years. According to Repouille: ‘He was just like dead all the time…. He couldn’t walk, he couldn’t talk, he couldn’t do anything.’ in the end Repouille killed his son with chloroform.
In 1988 a case arose that well illustrates the way in which modern medical technology forces us to make life and death decisions. Samuel Linares, an infant, swallowed a small object that stuck in his windpipe, causing a loss of oxygen to the brain. He was admitted to a Chicago hospital in a coma and placed on a respirator. Eight months later he was still comatose, still on the respirator, and the hospital was planning to move Samuel to a long-term care unit. Shortly before the move, Samuel’s parents visited him in the hospital. His mother left the room, while his father produced a pistol and told the nurse to keep away. He then disconnected Samuel from the respirator, and cradled the baby in his arms until he died. When he was sure Samuel was dead, he gave up his pistol and surrendered to police. He was charged with murder, but the grand jury refused to issue a homicide indictment, and he subsequently received a suspended sentence on a minor charge arising from the use of the pistol. Obviously, such cases raise different issues from those raised by voluntary euthanasia. There is no desire to die on the part of the infant. It may also be questioned whether, in such cases, the death is carried out for the sake of the infant, or for the sake of the family as a whole. If Louis Repouille’s son was ‘just like dead all the time’, then he may have been so profoundly brain- damaged that he was not capable of suffering at all. That is also likely to have been true of the comatose Samuel Linares. In that case, while caring for him would have been a great and no doubt futile burden for the family, and in the Linares case, a drain on the state’s limited medical resources as well, the infants were not suffering, and death could not be said to be in, or contrary to, their interests. It is therefore not euthanasia, strictly speaking, as I have defined the term. it might nevertheless be a justifiable ending of a human life.
Since cases of infanticide and non-voluntary euthanasia are the kind of case most nearly akin to our previous discussions of the status of animals and the human fetus, we shall consider them first.
JUSTIFYING INFANTICIDE AND NON-VOLUNTARY EUTHANASIA
As we have seen, euthanasia is non-voluntary when the subject has never had the capacity to choose to live or die. This is the situation of the severely disabled infant or the older human being who has been profoundly intellectually disabled since birth. Euthanasia or other forms of killing are also non- voluntary when the subject is not now but once was capable of making the crucial choice, and did not then express any preference relevant to her present condition.
The case of someone who has never been capable of choosing to live or die is a little more straightforward than that of a person who had, but has now lost, the capacity to make such a decision. We shall, once again, separate the two cases and take the more straightforward one first. For simplicity, I shall concentrate on infants, although everything I say about them would apply to older children or adults whose mental age is and has always been that of an infant.
Life and Death Decisions for Disabled Infants
If we were to approach the issue of life or death for a seriously disabled human infant without any prior discussion of the ethics of killing in general, we might be unable to resolve the conflict between the widely accepted obligation to protect the sanctity of human life, and the goal of reducing suffering. Some say that such decisions are ‘subjective’, or that life and death questions must be left to God and Nature. Our previous discussions have, however, prepared the ground, and the principles established and applied in the preceding three chapters make the issue much less baffling than most take it to be.
In Chapter 4 we saw that the fact that a being is a human being, in the sense of a member of the species Homo sapiens, is not relevant to the wrongness of killing it; it is, rather, characteristics like rationality, autonomy, and self-consciousness that make a difference. Infants lack these characteristics. Killing them, therefore, cannot be equated with killing normal human beings, or any other self-conscious beings. This conclusion is not limited to infants who, because of irreversible intellectual disabilities, will never be rational, self-conscious beings. We saw in our discussion of abortion that the potential of a fetus to become a rational, self-conscious being cannot count against killing it at a stage when it lacks these characteristics – not, that is, unless we are also prepared to count the value of rational self-conscious life as a reason against contraception and celibacy. No infant – disabled or not – has as strong a claim to life as beings capable of seeing themselves as distinct entities, existing over time.
The difference between killing disabled and normal infants lies not in any supposed right to life that the latter has and the former lacks, but in other considerations about killing. Most obviously there is the difference that often exists in the attitudes of the parents. The birth of a child is usually a happy event for the parents. They have, nowadays, often planned for the child. The mother has carried it for nine months. From birth, a natural affection begins to bind the parents to it. So one important reason why it is normally a terrible thing to kill an infant is the effect the killing will have on its parents.
It is different when the infant is born with a serious disability. Birth abnormalities vary, of course. Some are trivial and have little effect on the child or its parents; but others turn the normally joyful event of birth into a threat to the happiness of the parents, and any other children they may have.
Parents may, with good reason, regret that a disabled child was ever born. In that event the effect that the death of the child will have on its parents can be a reason for, rather than against killing it. Some parents want even the most gravely disabled infant to live as long as possible, and this desire would then be a reason against killing the infant. But what if this is not the case? in the discussion that follows I shall assume that the parents do not want the disabled child to live. I shall also assume that the disability is so serious that – again in contrast to the situation of an unwanted but normal child today – there are no other couples keen to adopt the infant. This is a realistic assumption even in a society in which there is a long waiting- list of couples wishing to adopt normal babies. It is true that from time to time cases of infants who are severely disabled and are being allowed to die have reached the courts in a glare of publicity, and this has led to couples offering to adopt the child. Unfortunately such offers are the product of the highly publicised dramatic life-and-death situation, and do not extend to the less publicised but far more cormnon situations in which parents feel themselves unable to look after a severely disabled child, and the child then languishes in an institution.
Infants are sentient beings who are neither rational nor self- conscious. So if we turn to consider the infants in themselves, independently of the attitudes of their parents, since their species is not relevant to their moral status, the principles that govern the wrongness of killing non-human animals who are sentient but not rational or self-conscious must apply here too. As we saw, the most plausible arguments for attributing a right to life to a being apply only if there is some awareness of oneself as a being existing over time, or as a continuing mental self. Nor can respect for autonomy apply where there is no capacity for autonomy. The remaining principles identified in Chapter 4 are utilitarian. Hence the quality of life that the infant can be expected to have is important.
One relatively common birth disability is a faulty development of the spine known as spina bifida. Its prevalence, varies in different countries, but it can affect as many as one in five hundred live births. In the more severe cases, the child will be permanently paralysed from the waistdown and lack control of bowels or bladder. Often excess fluid accumulates in the brain, a condition known as hydrocephalus, which can result in intellectual disabilities. Though some forms of treatment exist, if the child is badly affected at birth, the paralysis, incontinence, and intellectual disability cannot be overcome.
Some doctors closely connected with children suffering from severe spina bifida believe that the lives of the worst affected children are so miserable that it is wrong to resort to surgery to keep them alive. Published descriptions of the lives of these children support the judgment that these worst affected children will have lives filled with pain and discomfort. They need repeated major surgery to prevent curvature of the spine, due to the paralysis, and to correct other abnormalities. Some children with spina bifida have had forty major operations before they reach their teenage years.
When the life of an infant will be so miserable as not to be worth living, from the internal perspective of the being who will lead that life, both the ‘prior existence’ and the ‘total’ version of utilitarianism entail that, if there are no ‘extrinsic’ reasons for keeping the infant alive – like the feelings of the parents – it is better that the child should be helped to die without further suffering. A more difficult problem arises – and the convergence between the two views ends – when we consider disabilities that make the child’s life prospects significantly less promising than those of a normal child, but not so bleak as to make the child’s life not worth living. Haemophilia is probably in this category. The haemophiliac lacks the element in normal blood that makes it clot and thus risks prolonged bleeding, especially internal bleeding, from the slightest injury. if allowed to continue, this bleeding leads to permanent crippling and eventually death. The bleeding is very painful and although improved treatments have eliminated the need for constant blood transfusions, haemophiliacs still have to spend a lot of time in hospital. They are unable to play most sports and live constantly on the edge of crisis. Nevertheless, haemophiliacs do not appear to spend their time wondering whether to end it all; most find life definitely worth living, despite the difficulties they face.
Given these facts, suppose that a newborn baby is diagnosed as a haemophiliac. The parents, daunted by the prospect of bringing up a child with this condition, are not anxious for him to live. Could euthanasia be defended here? Our first reaction may well be a firm ‘no’, for the infant can be expected to have a life that is worth living, even if not quite as good as that of a normal baby. The ‘prior existence’ version of utilitarianism sup- ports this judgment. The infant exists. His life can be expected to contain a positive balance of happiness over misery. To kill him would deprive him of this positive balance of happiness. Therefore it would be wrong.
On the ‘total’ version of utilitarianism, however, we cannot reach a decision on the basis of this information alone. The total view makes it necessary to ask whether the death of the haemophiliac infant would lead to the creation of another being who would not otherwise have existed. In other words, if the haemophiliac child is killed, will his parents have another child whom they would not have if the haemophiliac child lives? If they would, is the second child likely to have a better life than the one killed?
Often it will be possible to answer both these questions affinnatively. A woman may plan to have two children. If one dies while she is of child-bearing age, she may conceive another in its place. Suppose a woman planning to have two children has one normal child, and then gives birth to a haemophiliac child. The burden of caring for that child may make it impossible for her to cope with a third child; but if the disabled child were to die, she would have another. It is also plausible to suppose that the prospects of a happy life are better for a normal child than for a haemophiliac.
When the death of a disabled infant will lead to the birth of another infant with better prospects of a happy life, the total amount of happiness will be greater if the disabled infant is killed. The loss of happy life for the first infant is outweighed by the gain of a happier life for the second. Therefore, if killing the haemophiliac infant has no adverse effect on others, it would, according to the total view, be right to kill him.
The total view treats infants as replaceable, in much the same way as it treats non-self-conscious animals (as we saw in Chapter 5). Many will think that the replaceability argument cannot be applied to human infants. The direct killing of even the most hopelessly disabled infant is still officially regarded as murder; how then could the killing of infants with far less serious problems, like haernophilia, be accepted? Yet on further reflection, the implications of the replaceability argument do not seem quite so bizarre. For there are disabled members of our species whom we now deal with exactly as the argument suggests we should. These cases closely resemble the ones we have been discussing. There is only one difference, and that is a difference of timing – the timing of the discovery of the problem, and the consequent killing of the disabled being.
Prenatal diagnosis is now a routine procedure for pregnant women. There are various medical techniques for obtaining information about the fetus during the early months of pregnancy. At one stage in the development of these procedures, it was possible to discover the sex of the fetus, but not whether the fetus would suffer from haemophilia. Haemophilia is a sex- linked genetic defect, from which only males suffer; females can carry the gene and pass it on to their male offspring without themselves being affected. So a woman who knew that she carried the gene for haemophilia could, at that stage, avoid giving birth to a haemophiliac child only by finding out the sex of the fetus, and aborting all males fetuses. Statistically, only half of these male children of women who carried the defective gene would have suffered from haernophilia, but there was then no way to find out to which half a particular fetus belonged. Therefore twice as many fetuses were being killed as necessary, in order to avoid the birth of children with haemophilia. This practice was widespread in many countries, and yet did not cause any great outcry. Now that we have techniques for identifying haemophilia before birth, we can be more selective, but the principle is the same: women are offered, and usually accept, abortions in order to avoid giving birth to children with haemophilia.
The same can be said about some other conditions that can be detected before birth. Down’s syndrome, formerly known as mongolism, is one of these. Children with this condition have intellectual disabilities and most will never be able to live in- dependently, but their lives, like those of small children, can be joyful. The risk of having a Down’s syndrome child increases sharply with the age of the mother, and for this reason prenatal diagnosis is routinely offered to pregnant women over 35. Again, undergoing the procedure implies that if the test for Down’s syndrome is positive, the woman will consider aborting the fetus and, if she still wishes to have another child, will start another pregnancy, which has a good chance of being normal.
Prenatal diagnosis, followed by abortion in selected cases, is common practice in countries with liberal abortion laws and advanced medical techniques. I think this is as it should be. As the arguments of Chapter 6 indicate, I believe that abortion can be justified. Note, however, that neither haemophilia nor Down’s syndrome is so crippling as to make life not worth living, from the inner perspective of the person with the condition. To abort a fetus with one of these disabilities, intending to have another child who will not be disabled, is to treat fetuses as interchangeable or replaceable. If the mother has previously decided to have a certain number of children, say two, then what she is doing, in effect, is rejecting one potential child in favour of another. She could, in defence of her actions, say: the loss of life of the aborted fetus is outweighed by the gain of a better life for the normal child who will be conceived only if the disabled one dies.
When death occurs before birth, replaceability does not conflict with generally accepted moral convictions. That a fetus is known to be disabled is widely accepted as a ground for abortion. Yet in discussing abortion, we saw that birth does not mark a morally significant dividing line. I cannot see how one could defend the view that fetuses may be ‘replaced’ before birth, but newborn infants may not be. Nor is there any other point, such as viability, that does a better job of dividing the fetus from the infant. Self-consciousness, which could provide a basis for holding that it is wrong to kill one being and replace it with another, is not to be found in either the fetus or the newborn infant. Neither the fetus nor the newborn infant is an individual capable of regarding itself as a distinct entity with a life of its own to lead, and it is only for newborn infants, or for still earlier stages of human life, that replaceability should be considered to be an ethically acceptable option.
It may still be objected that to replace either a fetus or a newborn infant is wrong because it suggests to disabled people living today that their lives are less worth living than the lives of people who are not disabled. Yet it is surely flying in the face of reality to deny that, on average, this is so. That is the only way to make sense of actions that we all take for granted. Recall thalidomide: this drug, when taken by pregnant women, caused many children to be born without arms or legs. Once the cause of the abnormal births was discovered, the drug was taken off the market, and the company responsible had to pay compensation. If we really believed that there is no reason to think of the life of a disabled person as likely to be any worse than that of a normal person, we would not have regarded this as a tragedy. No compensation would have been sought, or awarded by the courts. The children would merely have been ‘different’. We could even have left the drug on the market, so that women who found it a useful sleeping pill during pregnancy could continue to take it. If this sounds grotesque, that is only because we are all in no doubt at all that it is better to be born with limbs than without them. To believe this involves no disrespect at all for those who are lacking limbs; it simply recognises the reality of the difficulties they face.
In any case, the position taken here does not imply that it would be better that no people born with severe disabilities should survive; it implies only that the parents of such infants should be able to make this decision. Nor does this imply lack of respect or equal consideration for people with disabilities who are now living their own lives in accordance with their own wishes. As we saw at the end of Chapter 2, the principle of equal consideration of interests rejects any discounting of the interests of people on grounds of disability.
Even those who reject abortion and the idea that the fetus is replaceable are likely to regard possible people as replaceable. Recall the second woman in Parfit’s case of the two women, described in Chapter 5. She was told by her doctor that if she went ahead with her plan to become pregnant immediately, her child would have a disability (it could have been haemophilia); but if she waited three months her child would not have the disability. If we think she would do wrong not to wait, it can only be because we are comparing the two possible lives and judging one to have better prospects than the other. Of course, at this stage no life has begun; but the question is, when does a life, in the morally significant sense, really begin? in Chapters 4 and 5 we saw several reasons for saying that life only begins in the morally significant sense when there is awareness of one’s existence over time. The metaphor of life as a journey also provides a reason for holding that in infancy, life’s voyage has scarcely begun.
Regarding newborn infants as replaceable, as we now regard fetuses, would have considerable advantages over prenatal diagnosis followed by abortion. Prenatal diagnosis still cannot detect all major disabilities. Some disabilities, in fact, are not present before birth; they may be the result of extremely pre- mature birth, or of something going wrong in the birth process itself. At present parents can choose to keep or destroy their disabled offspring only if the disability happens to be detected during pregnancy. There is no logical basis for restricting parents’ choice to these particular disabilities. If disabled newborn infants were not regarded as having a right to life until, say, a week or a month after birth it would allow parents, in consultation with their doctors, to choose on the basis of far greater knowledge of the infant’s condition than is possible before birth. All these remarks have been concerned with the wrongness of ending the life of the infant, considered in itself rather than for its effects on others. When we take effects on others into account, the picture may alter. Obviously, to go through the whole of pregnancy and labour, only to give birth to a child who one decides should not live, would be a difficult, perhaps heartbreaking, experience. For this reason many women would prefer prenatal diagnosis and abortion rather than live birth with the possibility of infanticide; but if the latter is not morally worse than the former, this would seem to be a choice that the woman herself should be allowed to make.
Another factor to take into account is the possibility of adoption. When there are more couples wishing to adopt than nor- mal children available for adoption, a childless couple may be prepared to adopt a haemophiliac. This would relieve the mother of the burden of bringing up a haemophiliac child, and enable her to have another child, if she wished. Then the replaceability argument could not justify infanticide, for bringing the other child into existence would not be dependent on the death of the haemophiliac. The death of the haemophiliac would then be a straightforward loss of a life of positive quality, not outweighed by the creation of another being with a better life.
So the issue of ending life for disabled newborn infants is not without complications, which we do not have the space to discuss adequately. Nevertheless the main point is clear: killing a disabled infant is not morally equivalent to killing a person. Very often it is not wrong at all.
Other Non-voluntary Life and Death Decisions
In the preceding section we discussed justifiable killing for beings who have never been capable of choosing to live or die. Ending a life without consent may also be considered in the case of those who were once persons capable of choosing to live or die, but now, through accident or old age, have permanently lost this capacity, and did not, prior to losing it, express any views about whether they wished to go on living in such circumstances. These cases are not rare. Many hospitals care for motor accident victims whose brains have been damaged beyond all possible recovery. They may survive, in a coma, or perhaps barely conscious, for several years. In 1991, the Lancet reported that Rita Greene, a nurse, had been a patient at D.C. General Hospital in Washington for thirty-nine years without knowing it. Now aged sixty-three, she had been in a vegetative state since undergoing open heart surgery in 1952. The report stated that at any given time, between 5,000 and 10,000 Americans are surviving in a vegetative state. In other developed countries, where life-prolonging technology is not used so aggressively, there are far fewer long-term patients in this condition.
In most respects, these human beings do not differ importantly from disabled infants. They are not self-conscious, rational, or autonomous, and so considerations of a right to life or of respecting autonomy do not apply. If they have no experiences at all, and can never have any again, their lives have no intrinsic value. Their life’s journey has come to an end. They are biologically alive, but not biographically. (If this verdict seems harsh, ask yourself whether there is anything to choose between the following options: (a) instant death or (b) instant coma, followed by death, without recovery, in ten years’ time. I can see no advantage in survival in a comatose state, if death without recovery is certain.) The lives of those who are not in a coma and are conscious but not self-conscious have value if such beings experience more pleasure than pain, or have preferences that can be satisfied; but it is difficult to see the point of keeping such human beings alive if their life is, on the whole, miserable.
There is one important respect in which these cases differ from disabled infants. In discussing infanticide in the final section of Chapter 6, 1 cited Bentham’s comment that infanticide need not ‘give the slightest inquietude to the most timid imagination’. This is because those old enough to be aware of the killing of disabled infants are necessarily outside the scope of the policy. This cannot be said of euthanasia applied to those who once were rational and self-conscious. So a possible objection to this form of euthanasia would be that it will lead to insecurity and fear among those who are not now, but might come to be, within its scope. For instance, elderly people, knowing that non-voluntary euthanasia is sometimes applied to senile elderly patients, bedridden, suffering, and lacking the capacity to accept or reject death, might fear that every injection or tablet will be lethal. This fear might be quite irrational, but it would be difficult to convince people of this, particularly if old age really had affected their memory or powers of reasoning.
This objection might be met by a procedure allowing those who do not wish to be subjected to non-voluntary euthanasia under any circumstances to register their refusal. Perhaps this would suffice; but perhaps it would not provide enough reassurance. if not, non-voluntary euthanasia would be justifiable only for those never capable of choosing to live or die.
JUSTIFYING VOLUNTARY EUTHANASIA
Under existing laws in most countries, people suffering unrelievable pain or distress from an incurable illness who beg their doctors to end their lives are asking their doctors to risk a murder charge. Although juries are extremely reluctant to convict in cases of this kind the law is clear that neither the request, nor the degree of suffering, nor the incurable condition of the person killed, is a defence to a charge of murder. Advocates of voluntary euthanasia propose that this law be changed so that a doctor could legally act on a patient’s desire to die without further suffering. Doctors have been able to do this quite openly in the Netherlands, as a result of a series of court decisions during the 1980s, as long as they comply with certain conditions. In Ger- many, doctors may provide a patient with the means to end her life, but they may not administer the substance to her.
The case for voluntary euthanasia has some common ground with the case for non-voluntary euthanasia, in that death is a benefit for the one killed. The two kinds of euthanasia differ, however, in that voluntary euthanasia involves the killing of a person, a rational and self-conscious being and not a merely conscious being. (To be strictly accurate it must be said that this is not always so, because although only rational and self-conscious beings can consent to their own deaths, they may not be rational and self-conscious at the time euthanasia is contemplated – the doctor may, for instance, be acting on a prior written request for euthanasia if, through accident or illness, one’s rational faculties should be irretrievably lost. For simplicity we shall, henceforth, disregard this complication.)
We have seen that it is possible to justify ending the life of a human being who lacks the capacity to consent. We must now ask in what way the ethical issues are different when the being is capable of consenting, and does in fact consent.
Let us return to the general principles about killing proposed in Chapter 4. 1 argued there that killing a self-conscious being is a more serious matter than killing a merely conscious being. I gave four distinct grounds on which this could be argued:
1. The classical utilitarian claim that since self-conscious beings are capable of fearing their own death, killing them has worse effects on others. 2. The preference utilitarian calculation that counts the thwarting of the victim’s desire to go on living as an important reason against killing. 3. A theory of rights according to which to have a right one must have the ability to desire that to which one has a right, so that to have a right to life one must be able to desire one’s own continued existence. 4. Respect for the autonomous decisions of rational agents.
Now suppose we have a situation in which a person suffering from a painful and incurable disease wishes to die. if the individual were not a person – not rational or self-conscious – euthanasia would, as I have said, be justifiable. Do any of the four grounds for holding that it is normally worse to kill a person provide reasons against killing when the individual is a person who wants to die?
The classical utilitarian objection does not apply to killing that takes place only with the genuine consent of the person killed. That people are killed under these conditions would have no tendency to spread fear or insecurity, since we have no cause to be fearful of being killed with our own genuine consent. If we do not wish to be killed, we simply do not consent. In fact, the argument from fear points in favour of voluntary euthanasia, for if voluntary euthanasia is not permitted we may, with good cause, be fearful that our deaths will be unnecessarily drawn out and distressing. In the Netherlands, a nationwide study commissioned by the government found that ‘Many patients want an assurance that their doctor will assist them to die should suffering become unbearable.’ Often, having received this assurance, no persistent request for euthanasia eventuated. The availability of euthanasia brought comfort without euthanasia having to be provided.
Preference utilitarianism also points in favour of, not against, voluntary euthanasia. Just as preference utilitarianism must count a desire to go on living as a reason against killing, so it must count a desire to die as a reason for killing.
Next, according to the theory of rights we have considered, it is an essential feature of a right that one can waive one’s rights if one so chooses. I may have a right to privacy; but I can, if I wish, film every detail of my daily life and invite the neighbours to my home movies. Neighbours sufficiently intrigued to accept my invitation could do so without violating my right to privacy, since the right has on this occasion been waived. Similarly, to say that I have a right to life is not to say that it would be wrong for my doctor to end my life, if she does so at my request. In making this request I waive my right to life.
Lastly, the principle of respect for autonomy tells us to allow rational agents to live their own lives according to their own autonomous decisions, free from coercion or interference; but if rational agents should autonomously choose to die, then respect for autonomy will lead us to assist them to do as they choose.
So, although there are reasons for thinking that killing a self-conscious being is normally worse than killing any other kind of being, in the special case of voluntary euthanasia most of these reasons count for euthanasia rather than against. Surprising as this result might at first seem, it really does no more than reflect the fact that what is special about self-conscious beings is that they can know that they exist over time and will, unless they die, continue to exist. Normally this continued existence is fervently desired; when the foreseeable continued existence is dreaded rather than desired however, the desire to die may take the place of the normal desire to live, reversing the reasons against killing based on the desire to live. Thus the case for voluntary euthanasia is arguably much stronger than the case for non-voluntary euthanasia.
Some opponents of the legalisation of voluntary euthanasia might concede that all this follows, if we have a genuinely free and rational decision to die: but, they add, we can never be sure that a request to be killed is the result of a free and rational decision. Will not the sick and elderly be pressured by their relatives to end their lives quickly? Will it not be possible to commit outright murder by pretending that a person has requested euthanasia? And even if there is no pressure of falsification, can anyone who is ill, suffering pain, and very probably in a drugged and confused state of mind, make a rational decision about whether to live or die?
These questions raise technical difficulties for the legalisation of voluntary euthanasia, rather than objections to the under- lying ethical principles; but they are serious difficulties nonetheless. The guidelines developed by the courts in the Netherlands have sought to meet them by proposing that euthanasia is acceptable only if
Euthanasia in these circumstances is strongly supported by the Royal Dutch Medical Association, and by the general public in the Netherlands. The guidelines make murder in the guise of euthanasia rather far-fetched, and there is no evidence of an increase in the murder rate in the Netherlands.
It is often said, in debates about euthanasia, that doctors can be mistaken. In rare instances patients diagnosed by two competent doctors as suffering from an incurable condition have survived and enjoyed years of good health. Possibly the legalisation of voluntary euthanasia would, over the years, mean the deaths of a few people who would otherwise have recovered from their immediate illness and lived for some extra years. This is not, however, the knockdown argument against euthanasia that some imagine it to be. Against a very small number of unnecessary deaths that might occur if euthanasia is legalised we must place the very large amount of pain and distress that will be suffered if euthanasia is not legalised, by patients who really are terminally ill. Longer life is not such a supreme good that it outweighs all other considerations. (if it were, there would be many more effective ways of saving life – such as a ban on smoking, or a reduction of speed limits to 40 kilometres per hour – than prohibiting voluntary euthanasia.) The possibility that two doctors may make a mistake means that the person who opts for euthanasia is deciding on the balance of probabilities and giving up a very slight chance of survival in order to avoid suffering that will almost certainly end in death. This may be a perfectly rational choice. Probability is the guide of life, and of death, too. Against this, some will reply that improved care for the terminally ill has eliminated pain and made voluntary euthanasia unnecessary. Elisabeth Kubler-Ross, whose On Death and Dying is perhaps the best-known book on care for the dying, has claimed that none of her patients request euthanasia. Given personal attention an the right medication, she says, people come to accept their deaths and die peacefully without pain.
Kubler-Ross may be right. It may be possible, now, to eliminate pain. In almost all cases, it may even be possible to do it in a way that leaves patients in possession of their rational faculties and free from vomiting, nausea, or other distressing side-effects. Unfortunately only a minority of dying patients now receive this kind of care. Nor is physical pain the only problem. There can also be other distressing conditions, like bones so fragile they fracture at sudden movements, uncontrollable nausea and vomiting, slow starvation due to a cancerous growth, inability to control one’s bowels or bladder, difficulty in breathing, and so on.
Dr Timothy Quill, a doctor from Rochester, New York, has described how he prescribed barbiturate sleeping pills for ‘Diane’, a patient with a severe form of leukaemia, knowing that she wanted the tablets in order to be able to end her life. Dr Quill had known Diane for many years, and admired her courage in dealing with previous serious illnesses. in an article in the New England Journal of Medicine, Dr Quill wrote:
It was extraordinarily important to Diane to maintain control of herself and her own dignity during the time remaining to her. When this was no longer possible, she clearly wanted to die. As a former director of a hospice program, I know how to use pain medicines to keep patients comfortable and lessen suffering. I explained the philosophy of comfort care, which I strongly believe in. Although Diane understood and appreciated this, she had known of people lingering in what was called relative com- fort, and she wanted no part of it. When the time came, she wanted to take her life in the least painful way possible. Knowing of her desire for independence and her decision to stay in control, I thought this request made perfect sense…. In our discussion it became clear that preoccupation with her fear of a lingering death would interfere with Diane’s getting the most out of the time she had left until she found a safe way to ensure her death.
Not all dying patients who wish to die are fortunate enough to have a doctor like Timothy Quill. Betty Rollin has described, in her moving book Last Wish, how her mother developed ovarian cancer that spread to other parts of her body. One morning her mother said to her:
I’ve had a wonderful life, but now it’s over, or it should be. I’m not afraid to die, but I am afraid of this illness, what it’s doing to me…. There’s never any relief from it now. Nothing but nausea and this pain…. There won’t be any more chemotherapy. There’s no treatment anymore. So what happens to me now? I know what happens. I’ll die slowly …. I don’t want that …. Who does it benefit if I die slowly? if it benefits my children I’d be willing. But it’s not going to do you any good …. There’s no point in a slow death, none. I’ve never liked doing things with no point. I’ve got to end this.
Betty Rollin found it very difficult to help her mother to carry out her desire: ‘Physician after physician turned down our pleas for help (How many pills? What kind?).’ After her book about her mother’s death was published, she received hundreds of letters, many from people, or close relatives of people, who had tried to die, failed, and suffered even more. Many of these people were denied help from doctors, because although suicide is legal in most jurisdictions, assisted suicide is not.
Perhaps one day it will be possible to treat all terminally ill and incurable patients in such a way that no one requests euthanasia and the subject becomes a non-issue; but this is now just a utopian ideal, and no reason at all to deny euthanasia to those who must live and die in far less comfortable conditions. It is, in any case, highly paternalistic to tell dying patients that they are now so well looked after that they need not be offered the option of euthanasia. It would be more in keeping with respect for individual freedom and autonomy to legalise euthanasia and let patients decide whether their situation is bearable.
Do these arguments for voluntary euthanasia perhaps give too much weight to individual freedom and autonomy? After all, we do not allow people free choices on matters like, for instance, the taking of heroin. This is a restriction of freedom but, in the view of many, one that can be justified on paternalistic grounds. If preventing people from becoming heroin addicts is justifiable paternalism, why isn’t preventing people from having themselves killed?
The question is a reasonable one, because respect for individual freedom can be carded too far. John Stuart Mill thought that the state should never interfere with the individual except to prevent harm to others. The individual’s own good, Mill thought, is not a proper reason for state intervention. But Mill may have had too high an opinion of the rationality of a human being. It may occasionally be right to prevent people from making choices that are obviously not rationally based and that we can be sure they will later regret. The prohibition of voluntary euthanasia cannot be justified on paternalistic grounds, how- ever, for voluntary euthanasia is an act for which good reasons exist. Voluntary euthanasia occurs only when, to the best of medical knowledge, a person is suffering from an incurable and painful or extremely distressing condition. In these circumstances one cannot say that to choose to die quickly is obviously irrational. The strength of the case for voluntary euthanasia lies in this combination of respect for the preferences, or autonomy, of those who decide for euthanasia; and the clear rational basis of the decision itself.
NOT JUSTIFYING INVOLUNTARY EUTHANASIA
Involuntary euthanasia resembles voluntary euthanasia in that it involves the killing of those capable of consenting to their own death. It differs in that they do not consent. This difference is crucial, as the argument of the preceding section shows. All the four reasons against killing self-conscious beings apply when the person killed does not choose to die.
Would it ever be possible to justify involuntary euthanasia on paternalistic grounds, to save someone extreme agony? It might be possible to imagine a case in which the agony was so great, and so certain, that the weight of utilitarian considerations favouring euthanasia override all four reasons against killing self-conscious beings. Yet to make this decision one would have to be confident that one can judge when a person’s life is so bad as to be not worth living, better than that person can judge herself it is not clear that we are ever justified in having much confidence in our judgments about whether the life of another person is, to that person, worth living. That the other person wishes to go on living is good evidence that her life is worth living. What better evidence could there be?
The only kind of case in which the paternalistic argument is at all plausible is one in which the person to be killed does not realise what agony she will suffer in future, and if she is not killed now she will have to live through to the very end. On these grounds one might kill a person who has – though she does not yet realise it – fallen into the hands of homicidal sadists who will torture her to death. These cases are, fortunately, more commonly encountered in fiction than reality.
If in real life we are unlikely ever to encounter a case of justifiable involuntary euthanasia, then it may be best to dismiss from our minds the fanciful cases in which one might imagine defending it, and treat the rule against involuntary euthanasia as, for all practical purposes, absolute. Here [R. M.] Hare’s distinction between critical and intuitive levels of moral reasoning (see Chapter 4), is again relevant. The case described in the preceding paragraph is one in which, if we were reasoning at the critical level, we might consider involuntary euthanasia justifiable; but at the intuitive level, the level of moral reasoning we apply in our daily lives, we can simply say that euthanasia is only justifiable if those killed either
1. lack the ability to consent to death, because they lack the capacity to understand the choice between their own continued existence or non-existence; or 2. have the capacity to choose between their own continued life or death and to make an informed, voluntary, and settled decision to die.
ACTIVE AND PASSIVE EUTHANASIA
The conclusions we have reached in this chapter will shock a large number of readers, for they violate one of the most fundamental tenets of Western ethics – the wrongness of killing innocent human beings. I have already made one attempt to show that my conclusions are, at least in the area of disabled infants, a less radical departure from existing practice than one might suppose. I pointed out that many societies allow a pregnant woman to Ml a fetus at a late stage of pregnancy if there is a significant risk of it being disabled; and since the line between a developed fetus and a newborn infant is not a crucial moral divide, it is difficult to see why it is worse to kill a newborn infant known to be disabled. In this section I shall argue that there is another area of accepted medical practice that is not intrinsically different from the practices that the arguments of this chapter would allow.
I have already referred to the birth defect known as spina bifida, in which the infant is born with an opening in the back, exposing the spinal cord. Until 1957, most of these infants died young, but in that year doctors began using a new kind of valve, to drain off the excess fluid that otherwise accumulates in the head with this condition. In some hospitals it then became standard practice to make vigorous efforts to save every spina bifida infant. The result was that few such infants died – but of those who survived, many were severely disabled, with gross paralysis, multiple deformities of the legs and spine, and no control of bowel or bladder. Intellectual disabilities were also common. in short, the existence of these children caused great difficulty for their families and was often a misery for the children themselves.
After studying the results of this policy of active treatment a British doctor, John Lorber, proposed that instead of treating all cases of spina bifida, only those who have the defect in a mild form should be selected for treatment. (He proposed that the final decision should be up to the parents, but parents nearly always accept the recommendations of the doctors.) This principle of selective treatment has now been widely accepted in many countries and in Britain has been recognised as legitimate by the Department of Health and Social Security. The result is that fewer spina bifida children survive beyond infancy, but those who do survive are, by and large, the ones whose physical and mental disabilities are relatively minor.
The policy of selection, then, appears to be a desirable one:but what happens to those disabled infants not selected for treatment? Lorber does not disguise the fact that in these cases the hope is that the infant will die soon and without suffering. it is to achieve this objective that surgical operations and other forms of active treatment are not undertaken, although pain and discomfort are as far as possible relieved. If the infant happens to get an infection, the kind of infection that in a normal infant would be swiftly cleared up with antibiotics, no antibiotics are given. Since the survival of the infant is not desired, no steps are taken to prevent a condition, easily curable by ordinary medical techniques, proving fatal.
All this is, as I have said, accepted medical practice. in articles in medical journals, doctors have described cases in which they have allowed infants to die. These cases are not limited to spina bifida, but include, for instance, babies born with Down’s syndome and other complications. In 1982, the ‘Baby Doe’ case brought this practice to the attention of the American public. ‘Baby Doe’ was the legal pseudonym of a baby born in Bloomington, Indiana, with Down’s syndrome and some additional problems. The most serious of these was that the passage from the mouth to the stomach – the oesophagus – was not property formed. This meant that Baby Doe could not receive nourishment by mouth. The problem could have been repaired by surgery – but in this case the parents, after discussing the situation with their obstetrician, refused permission for surgery. Without surgery, Baby Doe would soon die. Baby Doe’s father later said that as a schoolteacher he had worked closely with Down syndrome children, and that he and his wife had decided that it was in the best interests of Baby Doe, and of their family a whole (they had two other children), to refuse consent f the operation. The hospital authorities, uncertain of their leg position, took the matter to court. Both the local county court and the Indiana State Supreme Court upheld the parents’ rig] to refuse consent to surgery. The case attracted national made attention, and an attempt was made to take it to the U.S. Supreme Court, but before this could happen, Baby Doe died.
One result of the Baby Doe case was that the U.S. government headed at the time by President Ronald Reagan, who had come, to power with the backing of the right-wing religious ‘Moral Majority’, issued a regulation directing that all infants are to be given necessary life-saving treatment, irrespective of disability. But the new regulations were strongly resisted by the American Medical Association and the American Academy of Pediatrics. In court hearings on the regulations, even Dr C. Everett Koop, Reagan’s surgeon-general and the driving force behind the attempt to ensure that all infants should be treated, had to admit that there were some cases in which he would not provide life sustaining treatment. Dr Koop mentioned three conditions in which, he said, life-sustaining treatment was not appropriate anencephalic infants (infants born without a brain); infants who had, usually as a result of extreme prematurity, suffered such severe bleeding in the brain that they would never be able to breathe without a respirator and would never be able even to recognise another person; and infants lacking a major part of their digestive tract, who could only be kept alive by means o a drip providing nourishment directly into the bloodstream.
The regulations were eventually accepted only in a watered down form, allowing some flexibility to doctors. Even so, a subsequent survey of American paediatricians specialising in the care of newborn infants showed that 76 percent thought that the regulations were not necessary, 66 percent considered the regulations interfered with parents’ right to determine what course of action was in the best interests of their children, and 60 percent believed that the regulations did not allow adequate consideration of infants’ suffering.
In a series of British cases, the courts have accepted the view that the quality of a child’s life is a relevant consideration in deciding whether life-sustaining treatment should be provided. In a case called In re B, concerning a baby like Baby Doe, with Down’s syndrome and an intestinal obstruction, the court said that surgery should be carried out, because the infant’s life would not be’demonstrably awful’. in another case, Re C, where the baby had a poorly formed brain combined with severe physical handicaps, the court authorised the paediatric team to refrain from giving life-prolonging treatment. This was also the course taken in the case of Re Baby J: this infant was born extremely prematurely, and was blind and deaf and would probably never have been able to speak.
Thus, though many would disagree with Baby Doe’s parents about allowing a Down’s syndrome infant to die (because people with Down’s syndrome can live enjoyable lives and be warm and loving individuals), virtually everyone recognises that in more severe conditions, allowing an infant to die is the only humane and ethically acceptable course to take. The question is: if it is right to allow infants to die, why is it wrong to kill them?
This question has not escaped the notice of the doctors involved. Frequently they answer it by a pious reference to the nineteenth-century poet, Arthur Clough, who wrote:
Thou shalt not kill; but need’st not strive Officiously to keep alive.
Unfortunately for those who appeal to Clough’s immortal lines as an authoritative ethical pronouncement, they come from a biting satire – ‘The Latest Decalogue’ – the intent of which is to mock the attitudes described. The opening lines, for example, are:
Thou shalt have one god only; who Would be at the expense of two. No graven images may be Worshipped except the currency.
So Clough cannot be numbered on the side of those who think it wrong to kill, but right not to try too hard to keep alive. is there, nonetheless, something to be said for this idea? The view that there is something to be said for it is often termed ‘the acts and omissions doctrine’. It holds that there is an important moral distinction between performing an act that has certain consequences – say , the death of a disabled child – and omitting to do something that has the same consequences. if this doctrine is correct, the doctor who gives the child a lethal injection does wrong; the doctor who omits to give the child antibiotics, knowing full well that without antibiotics the child will die, does not.
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Posted: December 11, 2016 at 8:03 am
Cohousing is an intentional community of private homes clustered around shared space. Each attached or single family home has traditional amenities, including a private kitchen. Shared spaces typically feature a common house, which may include a large kitchen and dining area, laundry, and recreational spaces. Shared outdoor space may include parking, walkways, open space, and gardens. Neighbors also share resources like tools and lawnmowers.
Households have independent incomes and private lives, but neighbors collaboratively plan and manage community activities and shared spaces. The legal structure is typically an HOA, Condo Association, or Housing Cooperative. Community activities feature regularly-scheduled shared meals, meetings, and workdays. Neighbors gather for parties, games, movies, or other events. Cohousing makes it easy to form clubs, organize child and elder care, and carpool.
Cohousing facilitates interaction among neighbors for social and practical benefits, economic and environmental benefits.
Neighbors commit to being part of a community for everyones mutual benefit. Cohousing cultivates a culture of sharing and caring. Design features and neighborhood size (typically 20-40 homes) promote frequent interaction and close relationships.
Cohousing neighborhoods are designed for privacy as well as community. Residents balance privacy and community by choosing their own level of engagement.
Decision making is participatory and often based on consensus. Self-management empowers residents, builds community, and saves money.
Cohousing communities support residents in actualizing shared values. Cohousing communities typically adopt green approaches to living.
The modern theory of cohousing originated in Denmark in the 1960s among groups of families who were dissatisfied with existing housing and communities that they felt did not meet their needs. Bodil Graae wrote a newspaper article titled “Children Should Have One Hundred Parents,” spurring a group of 50 families to organize around a community project in 1967. This group developed the cohousing project Sttedammen, which is the oldest known modern cohousing community in the world. Another key organizer was Jan Gudmand Hyer who drew inspiration from his architectural studies at Harvard and interaction with experimental U.S. communities of the era. He published the article “The Missing Link between Utopia and the Dated Single Family House”  in 1968, converging a second group.
The Danish term bofllesskab (living community) was introduced to North America as cohousing by two American architects, Kathryn McCamant and Charles Durrett, who visited several cohousing communities and wrote a book about it. The book resonated with some existing and forming communities, such as Sharingwood in Washington state and N Street in California, who embraced the cohousing concept as a crystallization of what they were already about. Though most cohousing groups seek to develop multi-generational communities, some focus on creating senior communities. Charles Durrett later wrote a handbook on creating senior cohousing. The first community in the United States to be designed, constructed and occupied specifically for cohousing is Muir Commons in Davis, California.Architects, Kathryn McCamant and Charles Durrett were responsible for the programming and the design of the site plan, common house and private houses.
There are precedents for cohousing in the 1920s in New York with the cooperative apartment housing with shared facilities and good social interaction. The Siheyuan, or quadrangle design of housing in China has a shared courtyard and is thus similar in some respects to cohousing.
Cohousing communities are part of the new cooperative economy in the United States and are predicted to expand rapidly in the next few decades as individuals and families seek to live more sustainably, and in community with neighbors. Since the first cohousing community was completed in the U.S. Muir Commons in Davis, California, now celebrating 25 years more than 160 communities have been established in 25 states plus the District of Columbia, with more than 125 in process. For a listing of cohousing communities visit http://www.cohousing.org/directory. Most cohousing communities are intergenerational with both children and elders; in recent years, senior cohousing focused on older adult needs have grown. These communities come in a variety, but are often environment friendly and socially sustainable.
Hundreds of cohousing communities exist in Denmark and other countries in northern Europe. In Canada, there are 11 completed communities, and approximately 19 in the forming or development phase (see ). There are more than 300 cohousing communities in the Netherlands (73 mixed-generation and 231 senior cohousing), with about 60 others in planning or construction phases.  There are also communities in Australia (see Cohousing Australia), the United Kingdom (see UK Cohousing Network http://www.cohousing.org.uk for information, Threshold Centre Cohousing Community http://www.thresholdcentre.org.uk/ offers training), and other parts of the world.
Cohousing started to develop in the UK at the end of the 1990s. The movement has gradually built up momentum and there are now 14 purpose built cohousing communities. A further 40+ cohousing groups are developing projects and new groups are forming all the time. Cohousing communities in the UK range from around 8 households to around 30 households. Most communities are mixed communities with single people, couples and families but some are only for people over 50 and one is only for women over 50 years. The communities themselves range from new developments built to modern eco standards to conversions of everything from farms to Jacobean mansions to former hospital buildings and are in urban, rural and semi- rural locations.
Because each cohousing community is planned in its context, a key feature of this model is its flexibility to the needs and values of its residents and the characteristics of the site. Cohousing can be urban, suburban or rural. The physical form is typically compact but varies from low-rise apartments to townhouses to clustered detached houses. They tend to keep cars to the periphery which promotes walking through the community and interacting with neighbors as well as increasing safety for children at play within the community. Shared green space is another characteristic, whether for gardening, play, or places to gather. When more land is available than is needed for the physical structures, the structures are usually clustered closely together, leaving as much of the land as possible “open” for shared use. This aspect of cohousing directly addresses the growing problem of suburban sprawl.
In addition to “from-scratch” new-built communities (including those physically retrofitting/re-using existing structures), there are also “retrofit” (aka “organic”) communities in which neighbors create “intentional neighborhoods” by buying adjacent properties and removing fences. Often, they create common amenities such as Common Houses after the fact, while living there. N Street Cohousing in Davis, CA, is the canonical example of this type; it came together before the term Cohousing was popularized here.
Cohousing differs from some types of intentional communities in that the residents do not have a shared economy or a common set of beliefs or religion, but instead invest in creating a socially rich and interconnected community. A non-hierarchical structure employing a consensus decision-making model is common in managing cohousing. Individuals do take on leadership roles, such as being responsible for coordinating a garden or facilitating a meeting.
Cohousing communities in the U.S. currently rely on one of two existing legal forms of real estate ownership: individually titled houses with common areas owned by a homeowner association(condominium)s or a housing cooperative. Condo ownership is most common because it fits financial institutions’ and cities’ models for multi-unit owner-occupied housing development. U.S. banks lend more readily on single-family homes and condominiums than housing cooperatives. Charles Durrett points out that rental cohousing is a very likely future model, as it has already is being practiced in Europe.
Cohousing differs from standard condominium development and master-planned subdivisions because the development is designed by, or with considerable input from, its future residents. The design process invariably emphasizes consciously fostering social relationships among its residents. Common facilities are based on the actual needs of the residents, rather than on what a developer thinks will help sell units. Turnover in cohousing developments is typically very low, and there is usually a waiting list for units to become available.
In Europe the term “joint building ventures” has been coined to define the form of ownership and housing characterized as cohousing. According to the European Urban Knowledge Network (EUKN): “Joint building ventures are a legal federation of persons willing to build who want to create owner-occupied housing and to participate actively in planning and building.”
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Posted: December 10, 2016 at 1:44 pm
Human height or stature is the distance from the bottom of the feet to the top of the head in a human body, standing erect. It is measured using a stadiometer, usually in centimetres when using the metric system, or feet and inches when using the imperial system.
When populations share genetic background and environmental factors, average height is frequently characteristic within the group. Exceptional height variation (around 20% deviation from average) within such a population is sometimes due to gigantism or dwarfism, which are medical conditions caused by specific genes or endocrine abnormalities.
The development of human height can serve as an indicator of two key welfare components, namely nutritional quality and health. In regions of poverty or warfare, environmental factors like chronic malnutrition during childhood or adolescence may result in delayed growth and/or marked reductions in adult stature even without the presence of any of these medical conditions.
The study of height is known as auxology. Growth has long been recognized as a measure of the health of individuals, hence part of the reasoning for the use of growth charts. For individuals, as indicators of health problems, growth trends are tracked for significant deviations and growth is also monitored for significant deficiency from genetic expectations. Genetics is a major factor in determining the height of individuals, though it is far less influential in regard to differences among populations. Average height is relevant to the measurement of the health and wellness (standard of living and quality of life) of populations.
Attributed as a significant reason for the trend of increasing height in parts of Europe are the egalitarian populations where proper medical care and adequate nutrition are relatively equally distributed. Changes in diet (nutrition) and a general rise in quality of health care and standard of living are the cited factors in the Asian populations. Malnutrition including chronic undernutrition and acute malnutrition is known to have caused stunted growth in various populations. This has been seen in North Korea, parts of Africa, certain historical Europe, and other populations.Developing countries such as Guatemala have rates of stunting in children under 5 living as high as 82.2% in Totonicapn, and 49.8% nationwide.
Height measurements are by nature subject to statistical sampling errors even for a single individual.[clarification needed] In a clinical situation, height measurements are seldom taken more often than once per office visit, which may mean sampling taking place a week to several months apart. The smooth 50th percentile male and female growth curves illustrated above are aggregate values from thousands of individuals sampled at ages from birth to age 20. In reality, a single individual’s growth curve shows large upward and downward spikes, partly due to actual differences in growth velocity, and partly due to small measurement errors.
For example, a typical measurement error of plus or minus 0.5cm may completely nullify 0.5cm of actual growth resulting in either a “negative” 0.5cm growth (due to overestimation in the previous visit combined with underestimation in the latter), up to a 1.5cm growth (the first visit underestimating and the second visit overestimating) in the same elapsed time period between measurements. Note there is a discontinuity in the growth curves at age 2, which reflects the difference in recumbent length (with the child on his or her back), used in measuring infants and toddlers and standing height typically measured from age 2 onwards.
Height, like other phenotypic traits, is determined by a combination of genetics and environmental factors. A child’s height based on parental heights is subject to regression toward the mean, therefore extremely tall or short parents will likely have correspondingly taller or shorter offspring, but their offspring will also likely be closer to average height than the parents themselves. Genetic potential and a number of hormones, minus illness, is a basic determinant for height. Other factors include the genetic response to external factors such as diet, exercise, environment, and life circumstances.
Humans grow fastest (other than in the womb) as infants and toddlers, rapidly declining from a maximum at birth to roughly age 2, tapering to a slowly declining rate, and then during the pubertal growth spurt, a rapid rise to a second maximum (at around 1112 years for female, and 1314 years for male), followed by a steady decline to zero. On average, female growth speed trails off to zero at about 15 or 16 years, whereas the male curve continues for approximately 3 more years, going to zero at about 1820. These are also critical periods where stressors such as malnutrition (or even severe child neglect) have the greatest effect.
Moreover, the health of a mother throughout her life, especially during her critical period and pregnancy, has a role. A healthier child and adult develops a body that is better able to provide optimal prenatal conditions. The pregnant mother’s health is important for herself but also for the fetus as gestation is itself a critical period for an embryo/fetus, though some problems affecting height during this period are resolved by catch-up growth assuming childhood conditions are good. Thus, there is a cumulative generation effect such that nutrition and health over generations influences the height of descendants to varying degrees.
The age of the mother also has some influence on her child’s height. Studies in modern times have observed a gradual increase in height with maternal age, though these early studies suggest that trend is due to various socio-economic situations that select certain demographics as being more likely to have a first birth early in the mother’s life. These same studies show that children born to a young mother are more likely to have below-average educational and behavioural development, again suggesting an ultimate cause of resources and family status rather than a purely biological explanation.
It has been observed that first-born males are shorter than later-born males. However, more recently the reverse observation was made. The study authors suggest that the cause may be socio-economic in nature.
The precise relationship between genetics and environment is complex and uncertain. Differences in human height is 60%80% heritable, according to several twin studies and has been considered polygenic since the Mendelian-biometrician debate a hundred years ago. A genome-wide association (GWA) study of more than 180,000 individuals has identified hundreds of genetic variants in at least 180 loci associated with adult human height. The number of individuals has since been expanded to 253,288 individuals and the number of genetic variants identified is 697 in 423 genetic loci. In a separate study of body proportion using sitting-height ratio, it reports that these 697 variants can be partitioned into 3 specific classes, (1) variants that primarily determine leg length, (2) variants that primarily determine spine and head length, or (3) variants that affect overall body size. This gives insights into the biological mechanisms underlying how these 697 genetic variants affect overall height.
The effect of environment on height is illustrated by studies performed by anthropologist Barry Bogin and coworkers of Guatemala Mayan children living in the United States. In the early 1970s, when Bogin first visited Guatemala, he observed that Mayan Indian men averaged only 157.5 centimetres (5ft 2in) in height and the women averaged 142.2 centimetres (4ft 8in). Bogin took another series of measurements after the Guatemalan Civil War, during which up to a million Guatemalans fled to the United States. He discovered that Maya refugees, who ranged from six to twelve years old, were significantly taller than their Guatemalan counterparts. By 2000, the American Maya were 10.24cm (4.03in) taller than the Guatemalan Maya of the same age, largely due to better nutrition and health care. Bogin also noted that American Maya children had relatively longer legs, averaging 7.02cm (2.76in) longer than the Guatemalan Maya (a significantly lower sitting height ratio).
The Nilotic peoples of Sudan such as the Shilluk and Dinka have been described as some of the tallest in the world. Dinka Ruweng males investigated by Roberts in 195354 were on average 181.3 centimetres (5ft 1112in) tall, and Shilluk males averaged 182.6 centimetres (6ft 0in). The Nilotic people are characterized as having long legs, narrow bodies and short trunks, an adaptation to hot weather. However, male Dinka and Shilluk refugees measured in 1995 in Southwestern Ethiopia were on average only 1.764 m and 1.726 m tall, respectively. As the study points out, Nilotic people “may attain greater height if priviledged with favourable environmental conditions during early childhood and adolescence, allowing full expression of the genetic material.” Before fleeing, these refugees were subject to privation as a consequence of the succession of civil wars in their country from 1955 to the present. The tallest living married couple are ex-basketball players Yao Ming and Ye Li (both of China) who measure 228.6cm (7 ft 11 in) and 190.5cm (6 ft 3 in) respectively, giving a combined height of 419.1cm (13 ft 9 in). They married in Shanghai, China, on 6 August 2007.
In Tibet, the khampas are known for their great height. Khampa males are on average 180cm tall (5ft 11 in).
The people of the Dinaric Alps (mainly North Albanians and South Slavs) are on record as being the tallest in the world, with a male average height of 185.6cm (6ft 1.1 in) and female average height of 170.9cm (5ft 7.3 in).
Growth in stature, determined by its various factors, results from the lengthening of bones via cellular divisions chiefly regulated by somatotropin (human growth hormone (hGH)) secreted by the anterior pituitary gland. Somatotropin also stimulates the release of another growth inducing hormone Insulin-like growth factor 1 (IGF-1) mainly by the liver. Both hormones operate on most tissues of the body, have many other functions, and continue to be secreted throughout life; with peak levels coinciding with peak growth velocity, and gradually subsiding with age after adolescence. The bulk of secretion occurs in bursts (especially for adolescents) with the largest during sleep.
The majority of linear growth occurs as growth of cartilage at the epiphysis (ends) of the long bones which gradually ossify to form hard bone. The legs compose approximately half of adult human height, and leg length is a somewhat sexually dimorphic trait, with men having proportionately longer legs. Some of this growth occurs after the growth spurt of the long bones has ceased or slowed. The majority of growth during growth spurts is of the long bones. Additionally, the variation in height between populations and across time is largely due to changes in leg length. The remainder of height consists of the cranium. Height is sexually dimorphic and statistically it is more or less normally distributed, but with heavy tails. It has been shown that a log-normal distribution fits the data equally well, besides guaranteeing a non-negative lower confidence limit, which could otherwise attain a non-physical negative height value for arbitrarily large confidence levels.
Most intra-population variance of height is genetic. Short stature and tall stature are usually not a health concern. If the degree of deviation from normal is significant, hereditary short stature is known as familial short stature and tall stature is known as familial tall stature. Confirmation that exceptional height is normal for a respective person can be ascertained from comparing stature of family members and analyzing growth trends for abrupt changes, among others. There are, however, various diseases and disorders that cause growth abnormalities.
Most notably, extreme height may be pathological, such as gigantism resulting from childhood hyperpituitarism, and dwarfism which has various causes. Rarely, no cause can be found for extreme height; very short persons may be termed as having idiopathic short stature. The United States Food and Drug Administration (FDA) in 2003 approved hGH treatment for those 2.25 standard deviations below the population mean (approximately the lowest 1.2% of the population). An even rarer occurrence, or at least less used term and recognized “problem”, is idiopathic tall stature.
If not enough growth hormone is produced and/or secreted by the pituitary gland, then a patient with growth hormone deficiency can undergo treatment. This treatment involves the injection of pure growth hormone into thick tissue to promote growth.
Certain studies have shown that height is a factor in overall health while some suggest tallness is associated with better cardiovascular health and shortness with longevity. Cancer risk has also been found to grow with height.
Nonetheless, modern westernized interpretations of the relationship between height and health fail to account for the observed height variations worldwide. Cavalli-Sforza and Cavalli-Sforza note that variations in height worldwide can be partly attributed to evolutionary pressures resulting from differing environments. These evolutionary pressures result in height related health implications. While tallness is an adaptive benefit in colder climates such as found in Europe, shortness helps dissipate body heat in warmer climatic regions. Consequently, the relationships between health and height cannot be easily generalized since tallness and shortness can both provide health benefits in different environmental settings.
At the extreme end, being excessively tall can cause various medical problems, including cardiovascular problems, because of the increased load on the heart to supply the body with blood, and problems resulting from the increased time it takes the brain to communicate with the extremities. For example, Robert Wadlow, the tallest man known to verifiable history, developed trouble walking as his height increased throughout his life. In many of the pictures of the later portion of his life, Wadlow can be seen gripping something for support. Late in his life, although he died at age 22, he had to wear braces on his legs and walk with a cane; and he died after developing an infection in his legs because he was unable to feel the irritation and cutting caused by his leg braces.
Sources are in disagreement about the overall relationship between height and longevity. Samaras and Elrick, in the Western Journal of Medicine, demonstrate an inverse correlation between height and longevity in several mammals including humans.
Women whose height is under 150cm (4ft 11in) may have a small pelvis, resulting in such complications during childbirth as shoulder dystocia.
A study done in Sweden in 2005 has shown that there is a strong inverse correlation between height and suicide among Swedish men.
A large body of human and animal evidence indicates that shorter, smaller bodies age slower, and have fewer chronic diseases and greater longevity. For example, a study found eight areas of support for the “smaller lives longer” thesis. These areas of evidence include studies involving longevity, life expectancy, centenarians, male vs. female longevity differences, mortality advantages of shorter people, survival findings, smaller body size due to calorie restriction, and within species body size differences. They all support the conclusion that smaller individuals live longer in healthy environments and with good nutrition. However, the difference in longevity is modest. Several human studies have found a loss of 0.5 year/centimeter of increased height (1.2 yr/inch). But these findings do not mean that all tall people die young. Many live to advanced ages and some become centenarians.
There is a large body of research in psychology, economics, and human biology that has assessed the relationship between several seemingly innocuous physical features (e.g., body height) and occupational success. The correlation between height and success was explored decades ago. Shorter people are considered to have an advantage in certain sports (e.g., gymnastics, race car driving, etc.), whereas in many other sports taller people have a major advantage. In most occupational fields, body height is not relevant to how well people are able to perform, but nonetheless has been found to correlate with their success in several studies, although there may be other factors such as gender or socioeonomic status that explain this.
A demonstration of the height-success association can be found in the realm of politics. In the United States presidential elections, the taller candidate won 22 out of 25 times in the 20th century. Nevertheless, Ignatius Loyola, founder of the Jesuits, was 150cm (4ft 11in) and several prominent world leaders of the 20th century, such as Vladimir Lenin, Benito Mussolini, Nicolae Ceauescu and Joseph Stalin were of below average height. These examples, however, were all before modern forms of multi-media, i.e., television, which may further height discrimination in modern society. Further, growing evidence suggests that height may be a proxy for confidence, which is likewise strongly correlated with occupational success.
In the eighteenth and nineteenth centuries, people of European descent in North America were far taller than those in Europe and were the tallest in the world. The original indigenous population of Plains Native Americans was also among the tallest populations of the world at the time.
In the late nineteenth century, the Netherlands was a land renowned for its short population, but today its population is among the world’s tallest with young men averaging 183.8cm (6ft 0.4in) tall.
According to a study by economist John Komlos and Francesco Cinnirella, in the first half of the 18th century, the average height of an English male was 165cm (5ft 5 in), and the average height of an Irish male was 168cm (5ft 6 in). The estimated mean height of English, German, and Scottish soldiers was 163.6cm 165.9cm (5ft 4.4 in 5ft 5.3 in) for the period as a whole, while that of Irish was 167.9cm (5ft 6.1 in). The average height of male slaves and convicts in North America was 171cm (5ft 7 in).
American-born colonial soldiers of the late 1770s were on average more than 7.6cm (3 inches) taller than their English counterparts who served in Royal Marines at the same time.
Average height of Americans and Europeans decreased during periods of rapid industrialization, possibly due to rapid population growth and increased economic inequality. In early 19th century England, the difference between average height of English upper class youth (students of Sandhurst Military Academy) and English lower class youth (Marine Society boys) reached 22cm (8.7in), the highest that has been observed.
Data derived from burials show that before 1850, the mean stature of males and females in Leiden, Netherlands was respectively 166.7cm (5ft 5.6 in) and 156.7cm (5ft 1.7 in). The average height of 19-year-old Dutch orphans in 1865 was 160cm (5ft 3 in).
According to a study by J.W. Drukker and Vincent Tassenaar, the average height of Dutch decreased from 1830 to 1857, even while Dutch real GNP per capita was growing at an average rate of more than 0.5 percent per year. The worst decline were in urban areas that in 1847, the urban height penalty was 2.5cm (1in). Urban mortality was also much higher than rural regions. In 1829, the average urban and rural Dutchman was 164cm (5ft 4.6 in). By 1856, the average rural Dutchman was 162cm (5ft 3.8 in) and urban Dutchman was 158.5cm (5ft 2.4 in).
A 2004 report citing a 2003 UNICEF study on the effects of malnutrition in North Korea, due to “successive famines,” found young adult males to be significantly shorter.[specify] In contrast South Koreans “feasting on an increasingly Western-influenced diet,” without famine, were growing taller. The height difference is minimal for Koreans over 40, who grew up at a time when economic conditions in the North were roughly comparable to those in the South, while height disparities are most acute for Koreans who grew up in the mid-1990s a demographic in which South Koreans are about 12cm (4.7in) taller than their North Korean counterparts as this was a period during which the North was affected by a harsh famine. A study by South Korean anthropologists of North Korean children who had defected to China found that 18-year-old males were 5inches (13cm) shorter than South Koreans their age due to malnutrition.
The tallest living man is Sultan Ksen of Turkey, at 251cm (8ft 3in). The tallest man in modern history was Robert Pershing Wadlow (19181940), from Illinois, in the United States, who was 272cm (8ft 11in) at the time of his death. The tallest woman in medical history was Zeng Jinlian of Hunan, China, who stood 248cm (8ft 112in) when she died at the age of 17. The shortest adult human on record was Chandra Bahadur Dangi of Nepal at 54.6cm (1ft 912in).
Adult height between populations often differs significantly. For example, the average height of women from the Czech Republic is greater than that of men from Malawi. This may be caused by genetic differences, childhood lifestyle differences (nutrition, sleep patterns, physical labor), or both.
Depending on sex, genetic and environmental factors, shrinkage of stature may begin in middle age in some individuals but tends to be universal in the extremely aged. This decrease in height is due to such factors as decreased height of inter-vertebral discs because of desiccation, atrophy of soft tissues and postural changes secondary to degenerative disease.
As with any statistical data, the accuracy of such data may be questionable for various reasons:
The rest is here:
Human height – Wikipedia
Posted: November 23, 2016 at 10:05 pm
Voluntary euthanasia is the practice of ending a life in a painless manner. Voluntary euthanasia (VE) and physician-assisted suicide (PAS) have been the focus of great controversy in recent years.
As of 2009, some forms of voluntary euthanasia are legal in Belgium,Luxembourg, the Netherlands,Switzerland, and Canada.
Voluntary refusal of food and fluids (VRFF) or Patient Refusal of Nutrition and Hydration (PRNH) is bordering on euthanasia. Some authors classify it as a form of passive euthanasia, while others treat it separately because it is treated differently from legal point of view and often perceived as a more ethical option. VRFF is sometimes suggested as a legal alternative to euthanasia in jurisdictions disallowing euthanasia.
Assisted suicide is a practice in which a person receives assistance in bringing about their death, typically people suffering from a severe physical illness, in which the final step in the process is actively performed by the person concerned. In physician-assisted suicide (also called physician aid-in-dying or PAD) a physician knowingly provides a competent but suffering patient, upon the patient’s request, with the means by which the patient intends to end his or her own life. Assisted suicide is contrasted with “active euthanasia” when the difference between providing the means and actively administering lethal medicine is considered important. For example, Swiss law allows assisted suicide while all forms of active euthanasia (like lethal injection) remain prohibited.
The term euthanasia comes from the Greek words “eu”-meaning good and “thanatos”-meaning death, which combined means well-death or “dying well”. Hippocrates mentions euthanasia in the Hippocratic Oath, which was written between 400 and 300 BC The original Oath states: To please no one will I prescribe a deadly drug nor give advice which may cause his death. Despite this, the ancient Greeks and Romans generally did not believe that life needed to be preserved at any cost and were, in consequence, tolerant of suicide in cases where no relief could be offered to the dying or, in the case of the Stoics and Epicureans, where a person no longer cared for his life.
English Common Law from the 14th century until the middle of the last century made suicide a criminal act in England and Wales. Assisting others to kill themselves remains illegal in that jurisdiction. However, in the 16th century, Thomas More, considered a saint by Roman Catholics, described a utopian community and envisaged such a community as one that would facilitate the death of those whose lives had become burdensome as a result of “torturing and lingering pain”, see The meaning of the work.
Since the 19th century, euthanasia has sparked intermittent debates and activism in North America and Europe. According to medical historian Ezekiel Emanuel, it was the availability of anesthesia that ushered in the modern era of euthanasia. In 1828, the first known anti-euthanasia law in the United States was passed in the state of New York, with many other localities and states following suit over a period of several years. After the Civil War, voluntary euthanasia was promoted by advocates, including some doctors. Support peaked around the start of the 20th century in the US and then grew again in the 1930s.
In an article in the Bulletin of the History of Medicine, Brown University historian Jacob M. Appel documented extensive political debate over legislation to legalize physician-assisted suicide in both Iowa and Ohio in 1906. Appel indicates social activist Anna S. Hall was the driving force behind this movement. According to historian Ian Dowbiggin, leading public figures, including Clarence Darrow and Jack London, advocated for the legalization of euthanasia.
Euthanasia societies[which?] were formed in England in 1935 and in the USA in 1938 to promote euthanasia. Although euthanasia legislation did not pass in the USA or England, in 1937, doctor-assisted euthanasia was declared legal in Switzerland as long as the doctor ending the life had nothing to gain. During this same era, US courts tackled cases involving critically ill people who requested physician assistance in dying as well as mercy killings, such as by parents of their severely disabled children.
During the post-war period, prominent proponents of euthanasia included Glanville Williams (The Sanctity of Life and the Criminal Law) and clergyman Joseph Fletcher (“Morals and medicine”). By the 1960s, advocacy for a right-to-die approach to voluntary euthanasia increased.
In 1996, the world’s first euthanasia legislation, the Rights of the Terminally Ill Act 1996, was passed in the Northern Territory of Australia. Four patients died through assisted suicide under the Act, using a device designed by Dr Philip Nitschke. The legislation was overturned by Australias Federal Parliament in 1997. In response to the overturning of the Act, Nitschke founded EXIT International. In 2009, an Australian quadriplegic was granted the right to refuse sustenance and be allowed to die. The Supreme Court of Western Australia ruled that it was up to Christian Rossiter, aged 49, to decide if he was to continue to receive medical care (tube feeding) and that his carers had to abide by his wishes. Chief Justice Wayne Martin also stipulated that his carers, Brightwater Care, would not be held criminally responsible for following his instructions. Rossiter died on 21 September 2009 following a chest infection.
In 1957 in Britain, Judge Devlin ruled in the trial of Dr John Bodkin Adams that causing death through the administration of lethal drugs to a patient, if the intention is solely to alleviate pain, is not considered murder even if death is a potential or even likely outcome. In 1993, the Netherlands decriminalized doctor-assisted suicide, and in 2002, restrictions were loosened. During that year, physician-assisted suicide was approved in Belgium. Belgium’s at the time most famous author Hugo Claus, suffering from Alzheimer’s disease, was among those that asked for euthanasia. He died in March 2008, assisted by an Antwerp doctor.
A key turning point in the debate over voluntary euthanasia (and physician assisted dying), at least in the United States, was the public furor over the Karen Ann Quinlan case. The Quinlan case paved the way for legal protection of voluntary passive euthanasia. In 1977, California legalized living wills and other states soon followed suit.
In 1980 the Hemlock Society USA was founded in Santa Monica by Derek Humphry. It was the first group in America to provide information to the terminally ill in case they wanted a hastened death. Hemlock also campaigned and partially financed drives to reform the law. In 2003 Hemlock was merged with End of Life Choices, which changed its name to Compassion and Choices.
In 1990, Dr. Jack Kevorkian, a Michigan physician, became famous for educating and assisting people in committing physician-assisted suicide, which resulted in a Michigan law against the practice in 1992. Kevorkian was tried and convicted in 1999 for a murder displayed on television. Also in 1990, the Supreme Court approved the use of non-active euthanasia.
In 1994, Oregon voters approved the Death with Dignity Act, permitting doctors to assist terminal patients with six months or less to live to end their lives. The U.S. Supreme Court allowed such laws in 1997. The Bush administration failed in its attempt to use drug law to stop Oregon in 2001, in the case Gonzales v. Oregon.
In 2005, amid U.S. government roadblocks and controversy, Terri Schiavo, a Floridian who had been in a vegetative state since 1990, had her feeding tube removed. Her husband had won the right to take her off life support, which he claimed she would want but was difficult to confirm as she had no living will and the rest of her family claimed otherwise.
In November 2008, Washington Initiative 1000 made Washington the second U.S. state to legalize physician-assisted suicide.
Euthanasia is a criminal offense in China. For example, in Shanghai a 67-year-old man was sentenced to 5 years in prison when he euthanized his 92-year-old mother when she emerged from a hospital procedure only able to move one finger and one toe. The sentence was considered lenient, because he had displayed filial piety toward his mother.
While active euthanasia remains illegal in China, it is gaining increasing acceptance among doctors and the general populace.
In Hong Kong, support for euthanasia among the general public is higher among those who put less importance on religious belief, those who are non-Christian, those who have higher family incomes, those who have more experience in taking care of terminally ill family members, and those who are older.
Since World War II, the debate over euthanasia in Western countries has centered on voluntary euthanasia within regulated health care systems. In some cases, judicial decisions, legislation, and regulations have made voluntary euthanasia an explicit option for patients and their guardians. Proponents and critics of such voluntary euthanasia policies offer the following reasons for and against official voluntary euthanasia policies:
Proponents of voluntary euthanasia emphasize that choice is a fundamental principle for liberal democracies and free market systems.
The pain and suffering a person feels during a disease, even with pain relievers, can be incomprehensible to a person who has not gone through it. Even without considering the physical pain, it is often difficult for patients to overcome the emotional pain of losing their independence.
Those who witness others die are “particularly convinced” that the law should be changed to allow assisted death.
Today in many countries there is a shortage of hospital space. Medical personnel and hospital beds could be used for people whose lives could be saved instead of continuing the lives of those who want to die, thus increasing the general quality of care and shortening hospital waiting lists. It is a burden to keep people alive past the point they can contribute to society, especially if the resources used could be spent on a curable ailment.
Critics argue that voluntary euthanasia could unduly compromise the professional roles of health care employees, especially doctors. They point out that European physicians of previous centuries traditionally swore some variation of the Hippocratic Oath, which in its ancient form excluded euthanasia: “To please no one will I prescribe a deadly drug nor give advice which may cause his death..” However, since the 1970s, this oath has largely fallen out of use.
Some people, including many Christians, consider euthanasia of some or all types to be morally unacceptable. This view usually treats euthanasia to be a type of murder and voluntary euthanasia as a type of suicide, the morality of which is the subject of active debate.
If there is some reason to believe the cause of a patient’s illness or suffering is or will soon be curable, the correct action is sometimes considered to attempt to bring about a cure or engage in palliative care.
Feasibility of implementation: Euthanasia can only be considered “voluntary” if a patient is mentally competent to make the decision, i.e., has a rational understanding of options and consequences. Competence can be difficult to determine or even define.
Consent under pressure: Given the economic grounds for voluntary euthanasia, critics of voluntary euthanasia are concerned that patients may experience psychological pressure to consent to voluntary euthanasia rather than be a financial burden on their families. Even where health costs are mostly covered by public money, as in most developed countries, voluntary euthanasia critics are concerned that hospital personnel would have an economic incentive to advise or pressure people toward euthanasia consent.
Non-voluntary euthanasia is sometimes cited as one of the possible outcomes of the slippery slope argument, in which it is claimed that permitting voluntary euthanasia to occur will lead to the support and legalization of non-voluntary and involuntary euthanasia.
The right to life movement opposes voluntary euthanasia.
Euthanasia brings about many ethical issues regarding a patients death. Some physicians say euthanasia is a rational choice for competent patients who wish to die to escape unbearable suffering.
Physicians who are in favor of euthanasia state that to keep euthanasia or physician-assisted suicide (PAS) illegal is a violation of patient freedoms. They believe that any competent terminally-ill patient should have the right to choose death or refuse life-saving treatment. Suicide and assistance from their physician is seen as the only option those patients have. With the suffering and the knowledge from the doctor, this may also suggest that PAS is a humane answer to the excruciating pain.
An argument against PAS is the violation of the Hippocratic oath that some doctors take. The Hippocratic oath states “I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan”.
Another reason for prohibiting PAS and euthanasia is the option of abusing PAS if it were to become legal. Poor or uninsured patients may not have the money or no access to proper care will have limited options, and they could be pressured towards assisted death.
During the 20th century, efforts to change government policies on euthanasia have met limited success in Western countries. Euthanasia policies have also been developed by a variety of NGOs, most notably medical associations and advocacy organizations.
There are many different religious views among on the issue of voluntary euthanasia, although many moral theologians are critical of the procedure.
Euthanasia can be accomplished either through an oral, intravenous, or intramuscular administration of drugs, or by oxygen deprivation (anoxia), as in some euthanasia machines. In individuals who are incapable of swallowing lethal doses of medication, an intravenous route is preferred. The following is a Dutch protocol for parenteral (intravenous) administration to obtain euthanasia:
Intravenous administration is the most reliable and rapid way to accomplish euthanasia. A coma is first induced by intravenous administration of 20mg/kg sodium thiopental (Nesdonal) in a small volume (10 ml physiological saline). Then a triple intravenous dose of a non-depolarizing neuromuscular muscle relaxant is given, such as 20mg pancuronium bromide (Pavulon) or 20mg vecuronium bromide (Norcuron). The muscle relaxant should preferably be given intravenously, in order to ensure optimal availability. Only for pancuronium bromide (Pavulon) are there substantial indications that the agent may also be given intramuscularly in a dosage of 40mg.
With regards to voluntary euthanasia, many people argue that ‘equal access’ should apply to access to suicide as well, so therefore disabled people who cannot kill themselves should have access to voluntary euthanasia.
Apart from The Old Law, a 17th-century tragicomedy written by Thomas Middleton, William Rowley, and Philip Massinger, one of the early books to deal with euthanasia in a fictional context is Anthony Trollope’s 1882 dystopian novel, The Fixed Period. Ricarda Huch’s novel The Deruga Case (1917) is about a physician who is acquitted after performing euthanasia on his dying ex-wife.
“Quality of Mercy” in The Prosecution Rests is a fable exploring the facets of aging, Alzheimer’s disease, and euthanasia. The story line makes no judgement but frees the reader to decide.
The plot of Christopher Buckley’s 2007 novel Boomsday involves the use of ‘Voluntary euthanasia’ of seniors as a political ploy to stave of the insolvency of social security as more and more of the aging US population reaches retirement age.
The films Children of Men and Soylent Green depict instances of government-sponsored euthanasia in order to strengthen their dystopian themes. The protagonist of the film Johnny Got His Gun is a brutally mutilated war veteran whose request for euthanasia furthers the work’s anti-war message. The recent films Mar Adentro and Million Dollar Baby argue more directly in favor of euthanasia by illustrating the suffering of their protagonists. These films have provoked debate and controversy in their home countries of Spain and the United States respectively.
In March 2010, the PBS Frontline TV program in the United States showed a documentary called “The Suicide Tourist” which told the story of Professor Craig Ewert, his family, and the Swiss group Dignitas, and their decision to commit assisted suicide in Switzerland after he was diagnosed and suffering with ALS (Lou Gehrig’s Disease).
Thrash metal band Megadeth’s 1994 album Youthanasia (the title is a pun on euthanasia) implies that society is euthanizing its youth.
The documentary film How to Die in Oregon follows the lives of select terminally ill individuals who weigh the options of continuing to live and euthanasia. This film employs emotional appeal to the audience on the controversial topic of voluntary euthanasia.
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Posted: at 10:04 pm
Offshore (Engels: weg van de kust), ook wel als buitengaats of aflandig aangeduid, is de aanduiding van activiteiten die plaatsvinden op enige afstand van de kust, meestal gericht op exploratie en winning van olie en gas, maar in toenemende mate ook van windenergie en aquacultuur. Het is onder te verdelen in een mijnbouwdeel met olie- en gasplatforms en een maritiem deel, zoals duikondersteuningsschepen, platformbevoorradingsschepen, pijpenleggers en kraanschepen. De offshore begon vlak na de Tweede Wereldoorlog, aanvankelijk vooral in de Golf van Mexico in ondiep water. Tegenwoordig vindt onder druk van de afnemende beschikbare hoeveelheid olie dicht bij de kust een verschuiving plaats naar diep water.
Onder offshoretechniek wordt verstaan het ontwerpen, construeren en plaatsen van kunstwerken die dienstdoen bij industrile processen of publieke voorzieningen en de exploratie en winning van olie en gas op zee.
Exploratie bestaat uit meerdere fases. Aanvankelijk begon dit met geologische opsporing, waarbij vooral oppervlaktegegevens worden genterpreteerd. In het midden van de jaren twintig van de twintigste eeuw waren alle aan de oppervlakte liggende velden in de Verenigde Staten in kaart gebracht en had men andere methoden nodig om dieper gelegen velden te vinden. De methodes van deze geofysische opsporing die op zee bruikbaar zijn, zijn seismiek, gravimetrie en magnetisch onderzoek, dat wordt uitgevoerd met onderzoeksvaartuigen. Bij veelbelovende aanwijzingen wordt een exploratieconcessie aangevraagd om daarna proefboringen te doen. Deze exploratieboring moet uitsluitsel geven of een formatie werkelijk olie of gas bevat. Dit vakgebied is de petrofysica. Deze proefboringen worden in ondiep water uitgevoerd door hefeilanden en in diep water door boorschepen en half-afzinkbare platforms. Met behulp van structurele geologie wordt daarna de omvang van een olie- of gasvoorkomen vastgesteld. Als die voldoende is, kan een oliemaatschappij besluiten tot winning over te gaan. Hiervoor worden productieputten geboord.
Al aan het einde van de negentiende eeuw werd in Californi, waar veel olie op natuurlijke wijze naar de oppervlakte lekt (seeps), net uit de kust gebouwd vanaf pieren in olievelden aan de wal die zich voortzetten in zee. Begin twintigste eeuw werd ook begonnen met boren naar vooral gas in het Eriemeer, voornamelijk aan de Canadese kant. Enkele jaren later werd ook in het Caddomeer op de grens van Louisiana en Texas geboord vanaf houten platforms. In Venezuela werd vanaf de jaren twintig in het Meer van Maracaibo naar olie geboord, terwijl in de jaren dertig werd begonnen in de Kaspische Zee.
In de jaren twintig van de twintigste eeuw gebruikte men in de moerassen, meren en baaien van Louisiana de houten platforms om vanaf te boren. In deze overgangszone onder invloed van het getij begon Chevron gebruik te maken van bakken om het materiaal sneller te kunnen verplaatsen. Ter plekke liet men deze afzinken tot op de bodem van het ondiepe water om daarna te boren. De eerste bak die op deze manier te werk ging, was de Giliasso, genoemd naar Louis Giliasso die dit idee had ontwikkeld. De stabiliteit van deze bakken was echter beperkt, zodat de waterdiepte waarin dit gebruikt kon worden, beperkt was tot zo’n drie meter. In 1937 lieten Pure Oil en Superior Oil door Brown & Root het tot dan toe grootste platform van de Golfkust bouwen, nog steeds van hout. In 1946 bouwde Brown & Root een platform met stalen palen voor Magnolia Petroleum.
Dit was echter allemaal dicht bij de kust. Begin 1947 liet Superior 18 mijl uit de kust bij Vermilion Parish een platform bouwen. Een platform van Kerr-McGee wist echter in oktober enkele maanden voor Superior een olieput in productie te brengen. Dit gebeurde in Ship Shoal Block 32 voor de kust van Louisiana in de Golf van Mexico met Rig 16 aan boord van de Frank Phillips. Dit wordt wel beschouwd als het begin van de offshore-industrie.
In de jaren vijftig verplaatste de boring zich naar steeds dieper water en werden eerst bakken en tenders kleine scheepsvormige bakken gebruikt. Later werden platforms gebruikt die naar locatie werden gesleept en daarna afgezonken tot ze rustten op de zeebodem. Deze afzinkers waren een idee van John T. Hayward die voor Barnsdall Oil & Gas werkte. Hierbij werden de voordelen van bakken gecombineerd met die van platforms op palen. Door op de bakken kolommen te plaatsen met daarop het werkdek was de invloed van de golven beperkt en had men toch een verplaatsbaar platform. De eerste was de Breton Rig 20, die in waterdieptes tot 6 meter kon werken. Nadat olie-exploratie in de Golf stil had gelegen van 1950 tot 1953 vanwege de Tidelands controversy, begon Alden J. Laborde zijn eigen bedrijf Odeco om met financiering van Murphy Oil een nieuw type afzinker te bouwen dat geschikt was voor dieper water. Dit platform, de Mr. Charlie, kon in waterdieptes tot 12 meter werken. Dit rechthoekige type werd snel populair, maar ook snel daarna vervangen door de ultieme afzinker het kolomgestabiliseerde platform of flessentype, waarvan de eerste Rig 46 was van Kerr-McGee in 1956. Dit type kon boren in waterdieptes tot 55 meter.
In waterdieptes verder uit de kust konden ook deze platforms echter niet meer aan het werk. Al in de jaren dertig werd gebruikgemaakt van hefeilanden voor constructiewerkzaamheden op zee en ook bij de landingen in Normandi tijdens D-Day werd hier gebruik van gemaakt. In 1950 liet Leon B. DeLong een aantal hefeilanden bouwen voor radarinstallaties in waterdieptes van 20 meter. De mobiliteit was een groot voordeel en in 1954 lieten meerdere bedrijven hefeilanden bouwen, waaronder Rig No. 51 van The Offshore Company en Mr. Gus van Glasscock Drilling. Tegenwoordig kan er met hefeilanden in waterdieptes tot 120 meter geboord worden.
De eerste half-afzinkbare platform werd per ongeluk uitgevonden in 1961. Blue Water Drilling Company bezat de uit vier kolommen bestaande afzinkbare Blue Water Rig No.1, gebouwd in 1957. Ze gebruikten deze voor Shell Oil Company in de Golf van Mexico om in 25 meter diep water te boren met het onderste deel van de romp op de bodem. Omdat de pontons niet genoeg drijfvermogen hadden om het totale gewicht van het rig te ondersteunen werd het naar locatie gesleept op een diepgang tussen de bovenzijde van de pontons en de onderzijde van het dek. Men merkte op dat de bewegingen veroorzaakt door de deining op deze diepgang gering waren vergeleken met conventionele schepen. Blue Water Drilling en Shell besloten gezamenlijk het platform drijvend te gebruiken voor boring.
Sindsdien worden half-afzinkbare platforms specifiek ontworpen voor de offshore industrie. In 1963 werd het eerste echte half-afzinkbare platform gebouwd, de Ocean Driller van Odeco. De grootste ramp met een half-afzinkbaar platform was het kapseizen van de Ocean Ranger, ook van Odeco, tijdens een storm op 15 februari 1982 op de Atlantische Oceaan, 315 kilometer zuidoost van St. John’s bij de Grand Banks, waarbij alle 84 bemanningsleden omkwamen.
Waar de waterdiepte in de Golf van Mexico geleidelijk toeneemt, is deze bij Californi al dicht bij de kust te diep voor platforms die op de zeebodem rusten. Om ook in deze wateren te kunnen boren, begon Shell in 1948 een consortium met Continental, Union en Superior (CUSS). In 1953 begonnen ze met proefboringen vanaf de verbouwde Submarex. Hierbij werd geboord vanaf een boorvloer over de zijde, wat problemen gaf met de slagzij. Hierop werd de CUSS I gebouwd, die boorde door een moonpool in de midscheeps. De CUSS I kon op ankers boren in waterdieptes tot ruim 100 meter.
De CUSS I werd overgenomen door Global Marine, die ook een serie grotere boorschepen liet bouwen. Bij grotere waterdieptes werd ankeren problematisch, en daarom maakte de CUSS I in 1961 tijdens Project Mohole een poging om door de aardkorst te boren in de Mohorovii-discontinuteit gebruik van schroeven om op positie te blijven bij een waterdiepte van zo’n 3500 meter, het begin van dynamic positioning. Desondanks maken nog veel boorschepen en semi-submersibles gebruik van ankersystemen, die lichter zijn geworden door over te stappen van kettingankers naar draadankers en zo bruikbaar zijn tot zeker 1500 meter en met vooraf geplaatste ankers tot nog minstens 1000 meter dieper.
De ontwikkelingen op de Noordzee begonnen pas later, mede door de zwaardere weersomstandigheden, maar vooral omdat gedacht was dat er niet voldoende olie en gas te winnen zou zijn. Daarnaast ontbrak internationale regelgeving over de verdeling van het continentaal plat. In 1958 werd het UNCLOS I verdrag (tegenwoordig onderdeel van het VN Zeerechtverdrag) afgesloten. In 1964 trad het in werking, zodat het continentaal plat van de Noordzee verdeeld werd tussen de aangrenzende landen. Op 29 mei 1959 werd in Kolham de Slochterse gasbel ontdekt, waarmee het vermoeden rees dat ook in de Noordzee aardgas zou zijn te vinden. Op 17 september 1965 boorde het hefeiland Sea Gem gas aan in de BP-concessie, om slechts enkele dagen later te kapseizen. De zware weersomstandigheden vereisten een aanpassing van de gebruikte technologie om veilig te kunnen werken.
Op 6 oktober 1973 brak de Jom Kipoeroorlog uit, waarna de OPEC een olie-embargo instelde voor de Verenigde Staten en Nederland, wat leidde tot de oliecrisis van 1973. Dit bleek een enorme stimulans voor de offshore-sector, vooral op de Noordzee.
Tegenwoordig is de offshore-industrie wereldwijd bezig met de exploratie en winning van olie en gas. Daarbij worden de Golf van Mexico, Brazili en West-Afrika wel gezien als de gouden driehoek, waarbij steeds meer de nadruk komt te liggen op diepwater ( 300 tot 2400 meter) en ultra-diepwater (meer dan 2400 meter).
De ontwikkeling van een olieveld bestaat uit meerdere onderdelen, waarvan het platform de meest zichtbare is, hoewel er ook velden zijn die geheel uit onderzeese installaties bestaan, zoals Ormen Lange. Daarnaast heeft een veld een infrastructuur, zoals olie- en gaspijpleidingen, waterinjectieleidingen, elektriciteitsleidingen en onderzeese installaties die aangelegd moeten worden. De constructie van platforms gebeurt grotendeels op werven aan de wal. De manier waarop deze daarna genstalleerd worden is onder andere afhankelijk van de grootte en de waterdiepte.
Met behulp van lanceerbakken kunnen jackets en compliant towers worden gelanceerd. Om kosten te reduceren nadat in 1986 de olieprijs was gedaald, werden jackets ontworpen die met een kraanschip konden worden genstalleerd. Omdat deze jackets niet ontworpen hoeven te worden voor de krachten die tijdens het lanceren optreden, kunnen deze lichter uitgevoerd worden dan gelanceerde jackets. Zwaardere jackets en compliant towers worden echter nog steeds gelanceerd.
Om op zee te hijsen, kan gebruik worden gemaakt van meerdere opties. Drijvende bokken werden al vroeg gebruikt. De komst van grote kraanschepen maakte constructie goedkoper.
De grootste kraanschepen worden gebruikt voor constructiewerkzaamheden in de offshore. De grotere schepen zijn vaak half-afzinkbaar, maar ook conventionele scheepsvormen (monohulls) worden gebruikt. Het verschil met een drijvende bok is dat de kranen kunnen roteren.
In 1949 liet J. Ray McDermott de Derrick Barge Four bouwen, een bak die uitgerust was met een 150 ton roterende kraan. Met het verschijnen van dit soort schepen veranderde de offshoreconstructie. In plaats van constructie in delen, kunnen jackets en dekken als modules aan de wal worden gebouwd. Voor gebruik in het ondiepe deel van de Golf van Mexico voldeden deze bakken voorlopig.
In 1963 liet Heerema een Noorse tanker, de Sunnaas, ombouwen tot het eerste kraanschip met een capaciteit van 300 ton in de offshore dat een echte scheepsvorm had, waarna het werd omgedoopt tot de Global Adventurer. Dit type kraanschip was beter geschikt voor de weersomstandigheden op de Noordzee.
Het in 1967 opgerichte Netherlands Offshore Company bracht in 1978 het eerste half-afzinkbaar kraanschip in de vaart, de Narwhal. Vanwege financile problemen werden de schepen van NOC verkocht aan McDermott, waarmee het bedrijf ophield te bestaan.
In datzelfde jaar liet Heerema ook twee half-afzinkbare kraanschepen bouwen, de Hermod en de Balder, elk met n 2000 shortton en n 3000 shortton kraan. Later hebben beide overigens een upgrade gekregen, zodat ze nu een grotere capaciteit hebben. Dit type kraanschip was veel minder gevoelig voor zeegang en deining, waardoor ook gedurende de wintermaanden kon worden gewerkt op de Noordzee. De grote stabiliteit laat ook toe dat er zwaarder getild kan worden dan met een monohull. De grotere werkbaarheid en capaciteit van de kranen bracht de installatietijd van een platform terug van een heel seizoen naar een paar weken. Waar de topside van een platform daarvoor opgebouwd moest worden uit vele kleine delen, kon deze nu veelal in een keer geplaatst worden, waardoor de totale constructie lichter uitgevoerd kon worden en een groter deel van het werk aan de wal plaats kon vinden en dus goedkoper was.
Genspireerd door dit succes werden gelijksoortige schepen gebouwd. In 1985 kwam de DB-102 in de vaart voor McDermott, met 2 kranen met een capaciteit van 6000 ton elk. Micoperi liet de M7000 bouwen in 1986 met twee kranen van 7000 ton elk.
Midden jaren tachtig was de hausse in de offshore echter over. De prijs van een vat olie daalde tot onder de $10 waardoor investeringen vrijwel tot stilstand kwamen en samenwerking gezocht moest worden. In 1988 werd een joint venture tussen Heerema en McDermott gevormd, HeereMac. In 1990 moest Micoperi een faillissement aanvragen. Dat gaf Saipem in het begin van de jaren zeventig nog een grote speler in de offshoreconstructie, maar eind jaren tachtig nog maar marginaal aanwezig de kans om in 1995 de M7000 over te nemen. In 1997 nam Heerema de DB-102 over van McDermott na beindiging van de joint venture. Het schip werd omgedoopt in Thialf en na een upgrade in 2000 tot tweemaal 7100 ton is het het grootste kraanschip ter wereld.
Voor dekken met gewichten die kraanschepen niet aankunnen of wanneer deze niet beschikbaar zijn, wordt gebruikgemaakt van bakken voor float-overs. Het gaat hierbij over gewichten van enkele tienduizenden tonnen. De bak wordt hierbij tussen de poten van het jacket gebracht en daarna geballast totdat het overhangende dek op het jacket staat.
Gravity based structures worden met behulp van sleepboten naar locatie gebracht, waarna ze geballast worden tot ze op de zeebodem rusten. Deze techniek is vooral veel gebruikt in Noorwegen, waar veel platforms van het condeeptype staan. Ook drijvende platforms als FPSO’s, TLP’s, semi-submersibles en spars worden naar locatie gesleept om daar vervolgens afgemeerd te worden.
De infrastructuur van een veld bestaat naast een of meerdere platforms uit olie- en gaspijpleidingen, waterinjectieleidingen, elektriciteitsleidingen en onderzeese installaties.
Hoewel ook de kleinere leidingen en installaties door de grote pijpenleggers en kraanschepen worden aangelegd, wordt dit vaak gedaan door zogenaamde Offshore Support Vessels. Deze zijn uitgerust met een kraan die vaak enkele tientallen tot honderden tonnen kan tillen, dan wel met een A-frame waarmee installaties op de zeebodem kunnen worden uitgevoerd.
In ondiep water wordt in de Verenigde Staten ook gebruikgemaakt van liftboten, bootjes met eigen voortstuwing die zich kunnen opheffen zoals een hefeiland en meestal uitgerust zijn met een kraan.
Bij onderzeese pijpleidingen voor een platform wordt onderscheid gemaakt tussen de leidingen waarmee de olie en gas uit diverse putten naar het platform wordt getransporteerd de tie-backs en die waarmee het na behandeling naar de wal wordt getransporteerd de exportleidingen. Export kan ook met behulp van een shuttletanker, maar vindt vaak plaats met behulp van een pijpleiding. Deze worden gelegd met behulp van bakken waarvan de ankers continu verplaatst worden door ankerbehandelingssleepboten. Tegenwoordig zijn de grootste pijpenleggers schepen en voorzien van dynamic positioning. Er zijn verschillende methoden om pijp te leggen. Bij S-lay verlaat de leiding het schip horizontaal, bij J-lay verticaal. Bij reel-lay wordt de pijp gelegd vanaf een grote spoel.
Waar hefeilanden en boorschepen vooral gebruikt worden voor proefboringen en om de uiteindelijke putten te boren, kunnen deze na voltooiing daarvan vertrekken. Na installatie van een productieplatform die vaak booreilanden worden genoemd, hoewel de meeste niet kunnen boren wordt de winning daarmee voortgezet. De beweging naar steeds dieper water heeft een scala aan platforms opgeleverd. Bij grotere waterdieptes werden de normale jackets te groot en zwaar om economisch nog haalbaar te zijn. Waar deze jackets stijf zijn ontworpen om alle weersomstandigheden te kunnen weerstaan, werd voor grotere waterdieptes overgestapt op buigzame constructies, compliant towers die meegeven en daardoor lichter gebouwd kunnen worden. Voor nog grotere waterdieptes ging men over naar drijvende platforms:
In de Verenigde Staten moet van de MMS een platform binnen een jaar na het buiten gebruik stellen worden verwijderd, tenzij gebruik wordt gemaakt van het alternatief volgens de Rigs-to-Reefs-wetgeving. In Europa was het dumpen van afval vanaf schepen en vliegtuigen aan banden gelegd door de Oslo-conventie van 1972, die later is vervangen door het OSPAR-verdrag. De Brent Spar-affaire zorgde voor een aanscherping van dit verdrag in 1998, zodat alle platforms in de Noordzee ontmanteld moeten worden, hoewel dit verdrag meer ruimte laat dan het Verdrag van Helsinki dat geldt voor de Oostzee. Een poging in 1996 om via het Verdrag van Londen het dumpen wereldwijd te verbieden mislukte.
Dit betekent dat er een ontmantelingsmarkt is van enkele honderden platforms op de Noordzee, hoewel deze markt riskanter is dan installatie. Aangezien er geen first oil is aan het einde van het project, is het al snel financieel aantrekkelijk voor een oliemaatschappij om investeringen naar achteren te verschuiven. Een aantal methodes en voorstellen voor ontmanteling zijn gebaseerd op het gebruik van dezelfde kraanschepen die ook voor installatie werden gebruikt.
Andere voorstellen baseren zich vooral op het catamaran-idee, waarbij tussen de twee rompen ruimte is uitgespaard. Deze U-vorm kan dan om een dek of jacket geplaatst worden, waarna ontballast wordt waarmee de constructie gelicht wordt. Andere voorstellen maken gebruik van hydraulische systemen en hijsdraden, eventueel gecombineerd. Voorbeelden zijn Versatruss, de Pieter Schelte van Allseas, de MPU Heavy Lifter van het inmiddels failliete MPU Offshore Lift en de Twin Marine Lifter. Hiervan bestaat alleen de eerste. De Pieter Schelte is nog in de ontwerpfase, de MPU Heavy Lifter wordt gesloopt voordat deze is voltooid en de Twin Marine Lifter is nog in de conceptfase.
Maritieme techniek houdt zich bezig met scheepsbouw en scheepvaart en richt zich ook op het transport van goederen en personen. Offshore is een vakgebied dat zich uit civiele techniek (de constructies), werktuigbouwkunde en scheepsbouwkunde heeft ontwikkeld. De laatste tijd verschuift het vakgebied meer naar de scheepsbouwkundige kant. Dit omdat offshore olie- en gasvelden zich op steeds grotere diepten bevinden. Hiermee komt de switch van ‘fixed platforms’ naar ‘floating platforms’; de laatste zijn vooral een scheepsbouwkundige aangelegenheid.
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Posted: October 31, 2016 at 2:52 am
Trance is a genre of electronic dance music that developed during the 1990s in Germany. It is characterized by a tempo lying between 125 and 150 beats per minute (BPM), repeating melodic phrases, and a musical form that distinctly builds tension and elements throughout a track often culminating in 1 to 2 “peaks” or “drops.” Although trance is a genre of its own, it liberally incorporates influences from other musical styles such as techno,house,pop,chill-out,classical music,tech house, ambient, and film music.
A trance refers to a state of hypnotism and heightened consciousness. This is portrayed in trance music by the mixing of layers with distinctly foreshadowed build-up and release. A characteristic of virtually all trance music is a mid-song climax followed by a soft breakdown disposing of beats and percussion entirely, and leaving the melody and/or atmospherics to stand alone for an extended period before gradually building up again. As a result, trance tracks are often lengthy to allow for this progression and have sufficiently sparse opening and closing sections to facilitate mixing by DJs.
Trance can be purely instrumental, although vocals are also a common feature. Typically they are performed by mezzo-soprano to soprano female soloists, often without verse/chorus structure. Structured vocal form in trance music forms the basis of the vocal trance subgenre, which has been described as “grand, soaring, and operatic” and “ethereal female leads floating amongst the synths”.
The trance name may refer to an induced emotional feeling, high, euphoria, chills, or uplifting rush that listeners claim to experience, or it may indicate an actual trance-like state the earliest forms of this music attempted to emulate in the 1990s before the genre’s focus changed.
Some trace Trance’s antecedents back to Klaus Schulze, a German experimental electronic music artist who concentrated in mixing minimalist music repetitive rhythms and arpeggiated sounds (specifically his 1988 album “En=Trance”. In truth it was really Sven Vth, his labels and others in the same group that saw the initial releases of trance Another possible antecedent is Yuzo Koshiro and Motohiro Kawashima’s electronic soundtracks for the Streets of Rage series of video games from 1991 to 1994, and the Wangan Midnight Maximum Tune series. It was promoted by the well-known UK club-night megatripolis (London, Heaven, Thursdays) whose scene catapulted it to international fame.
Examples of early Trance releases include but are not limited to German duo Jam & Spoon’s 1992 12″ Single remix of the 1990 song The Age Of Love., German duo Dance 2 Trance’s 1990 track “We Came in Peace”.
One writer[who?] traces the roots of trance to Paul van Dyk’s 1993 remix of Humate’s “Love Stimulation”. However, van Dyk’s trance origins can be traced further back to his work with Visions Of Shiva, which were his first ever tracks to be released.[original research?] In subsequent years, one genre, vocal trance, arose as the combination of progressive elements and pop music, and the development of another subgenre, epic trance, had some of its origins in classical music., with film music also being influential.
Trance was arguably at its commercial peak in the second part of 1990s and early 2000s.
Classic trance employs a 4/4 time signature, a tempo of 125 to 150 BPM, and 32 beat phrases and is somewhat faster than house music. A kick drum is usually placed on every downbeat and a regular open hi-hat is often placed on the upbeat or every 1/8th division of the bar. Extra percussive elements are usually added, and major transitions, builds or climaxes are often foreshadowed by lengthy “snare rolls”a quick succession of snare drum hits that build in velocity, frequency, and volume towards the end of a measure or phrase.
Rapid arpeggios and minor keys are common features of Trance, the latter being almost universal. Trance tracks often use one central “hook”, or melody, which runs through almost the entire song, repeating at intervals anywhere between 2 beats and 32 bars, in addition to harmonies and motifs in different timbres from the central melody. Instruments are added or removed every 4, 8, 16, or 32 bars.
In the section before the breakdown, the lead motif is often introduced in a sliced up and simplified form, to give the audience a “taste” of what they will hear after the breakdown. Then later, the final climax is usually “a culmination of the first part of the track mixed with the main melodic reprise”.
As is the case with many dance music tracks, trance tracks are usually built with sparser intros (“mix-ins”) and outros (“mix-outs”) in order to enable DJs to blend them together immediately. As trance is more melodic and harmonic than other electronic dance music, the construction of trance tracks in the proper way is particularly important in order to avoid dissonant (or “key clashing,” i.e., out of tune with one another) mixes.
More recent forms of trance music incorporate other styles and elements of electronic music such as electro and progressive house into its production. It emphasizes harsher basslines and drum beats which decrease the importance of offbeats and focus primarily on a four on the floor stylistic house drum pattern. The bpm of more recent styles tends to be on par with house music at 120 – 135 beats per minute. However, unlike house music, recent forms of trance stay true to their melodic breakdowns and longer transitions.
Trance music is broken into a large number of subgenres. Chronologically, the major subgenres are classic trance, acid trance, progressive trance,uplifting trance, and hard trance.Uplifting trance is also known as “anthem trance”, “epic trance”, “commercial trance”, “stadium trance”, or “euphoric trance”, and has been strongly influenced by classical music in the 1990s and 2000s by leading artists such as Ferry Corsten, Armin Van Buuren, Tiesto, Push, Rank 1 and at present with the development of the subgenre “orchestral uplifting trance” or “uplifting trance with symphonic orchestra” by such artists as Andy Blueman, Ciro Visone, Soundlift, Arctic Moon, Sergey Nevone&Simon O’Shine etc. Closely related to Uplifting Trance is Euro-trance, which has become a general term for a wide variety of highly commercialized European dance music. Several subgenres are crossovers with other major genres of electronic music. For instance, Tech trance is a mixture of trance and techno, and Vocal trance “combines [trance’s] progressive elements with pop music”.Balearic beat, which is associated with the laid back vacation lifestyle of Ibiza, Spain, is often called “Balearic trance”, as espoused by Roger Shah. The dream trance genre originated in the mid-1990s, with its popularity then led by Robert Miles. There is also a slower bpm trance music, this styles are often called “psybient” (synonyms are “psychill”, “ambient trance”).
AllMusic states on progressive trance: “the progressive wing of the trance crowd led directly to a more commercial, chart-oriented sound, since trance had never enjoyed much chart action in the first place. Emphasizing the smoother sound of Eurodance or house (and occasionally more reminiscent of Jean-Michel Jarre than Basement Jaxx), Progressive Trance became the sound of the world’s dance floors by the end of the millennium. Critics ridiculed its focus on predictable breakdowns and relative lack of skill to beat-mix, but progressive trance was caned by the hottest DJ.”
The following is an incomplete list of dance music festivals that showcase trance music.
Notes:’ Sunburn was not the first festival/event to specialize in India in trance music much earlier pioneers of Goa parties held events as early as the late 80’s and through all of the 1990s
Electronic Dance Music festivals in the Netherlands are mainly organized by four companies ALDA Events, ID&T, UDC and Q-dance:
Electronic music festivals in the US feature various Electronic Dance Music genres such as trance, House, Techno, Electro, Dubstep, and Drum & Bass:
The trance scene in South America is constantly growing. The most important trance festival in South America is called Universo Parallelo.
Posted: October 27, 2016 at 12:08 pm
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Name of the teacher who assigned the essay (if applicable) Your Essay Please select the topic question your essay addresses Topic 1: Francisco d’Anconia says that the “words ‘to make money’ Topic 2: Atlas Shrugged is both a celebration of business and a defense Topic 3: Ragnar Danneskjld says he loves that which has rarely been loved,
Francisco d’Anconia says that the “words ‘to make money’ hold the essence of human morality.” What does he mean? What are today’s prevalent moral attitudes toward money? Do you agree with Franciscos view? Explain why or why not.
Atlas Shrugged is both a celebration of business and a defense of it against widespread attacks. Judging from the novel, as well as from Ayn Rand’s essay “What Is Capitalism?” and her speech “America’s Persecuted Minority: Big Business,” why does she think business should be defended and championed? What does she think is a proper defense of business, and why?
Ragnar Danneskjld says he loves that which has rarely been loved, namely, human ability. What do you think this means? How does it relate to the idea: “From each according to his ability, to each according to his need”? Do you agree or disagree with Ragnar’s attitude? Explain.
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Posted: October 25, 2016 at 7:36 am
Gene therapy is the therapeutic delivery of nucleic acid polymers into a patient’s cells as a drug to treat disease. The first attempt at modifying human DNA was performed in 1980 by Martin Cline, but the first successful and approved[by whom?] nuclear gene transfer in humans was performed in May 1989. The first therapeutic use of gene transfer as well as the first direct insertion of human DNA into the nuclear genome was performed by French Anderson in a trial starting in September 1990.
Between 1989 and February 2016, over 2,300 clinical trials had been conducted, more than half of them in phase I.
It should be noted that not all medical procedures that introduce alterations to a patient’s genetic makeup can be considered gene therapy. Bone marrow transplantation and organ transplants in general have been found to introduce foreign DNA into patients. Gene therapy is defined by the precision of the procedure and the intention of direct therapeutic effects.
Gene therapy was conceptualized in 1972, by authors who urged caution before commencing human gene therapy studies.
The first attempt, an unsuccessful one, at gene therapy (as well as the first case of medical transfer of foreign genes into humans not counting organ transplantation) was performed by Martin Cline on 10 July 1980. Cline claimed that one of the genes in his patients was active six months later, though he never published this data or had it verified and even if he is correct, it’s unlikely it produced any significant beneficial effects treating beta-thalassemia.
After extensive research on animals throughout the 1980s and a 1989 bacterial gene tagging trial on humans, the first gene therapy widely accepted as a success was demonstrated in a trial that started on September 14, 1990, when Ashi DeSilva was treated for ADA-SCID.
The first somatic treatment that produced a permanent genetic change was performed in 1993.
This procedure was referred to sensationally and somewhat inaccurately in the media as a “three parent baby”, though mtDNA is not the primary human genome and has little effect on an organism’s individual characteristics beyond powering their cells.
Gene therapy is a way to fix a genetic problem at its source. The polymers are either translated into proteins, interfere with target gene expression, or possibly correct genetic mutations.
The most common form uses DNA that encodes a functional, therapeutic gene to replace a mutated gene. The polymer molecule is packaged within a “vector”, which carries the molecule inside cells.
Early clinical failures led to dismissals of gene therapy. Clinical successes since 2006 regained researchers’ attention, although as of 2014, it was still largely an experimental technique. These include treatment of retinal diseases Leber’s congenital amaurosis and choroideremia,X-linked SCID, ADA-SCID,adrenoleukodystrophy,chronic lymphocytic leukemia (CLL),acute lymphocytic leukemia (ALL),multiple myeloma,haemophilia and Parkinson’s disease. Between 2013 and April 2014, US companies invested over $600 million in the field.
The first commercial gene therapy, Gendicine, was approved in China in 2003 for the treatment of certain cancers. In 2011 Neovasculgen was registered in Russia as the first-in-class gene-therapy drug for treatment of peripheral artery disease, including critical limb ischemia. In 2012 Glybera, a treatment for a rare inherited disorder, became the first treatment to be approved for clinical use in either Europe or the United States after its endorsement by the European Commission.
Following early advances in genetic engineering of bacteria, cells, and small animals, scientists started considering how to apply it to medicine. Two main approaches were considered replacing or disrupting defective genes. Scientists focused on diseases caused by single-gene defects, such as cystic fibrosis, haemophilia, muscular dystrophy, thalassemia and sickle cell anemia. Glybera treats one such disease, caused by a defect in lipoprotein lipase.
DNA must be administered, reach the damaged cells, enter the cell and express/disrupt a protein. Multiple delivery techniques have been explored. The initial approach incorporated DNA into an engineered virus to deliver the DNA into a chromosome.Naked DNA approaches have also been explored, especially in the context of vaccine development.
Generally, efforts focused on administering a gene that causes a needed protein to be expressed. More recently, increased understanding of nuclease function has led to more direct DNA editing, using techniques such as zinc finger nucleases and CRISPR. The vector incorporates genes into chromosomes. The expressed nucleases then knock out and replace genes in the chromosome. As of 2014 these approaches involve removing cells from patients, editing a chromosome and returning the transformed cells to patients.
Gene editing is a potential approach to alter the human genome to treat genetic diseases, viral diseases, and cancer. As of 2016 these approaches were still years from being medicine.
Gene therapy may be classified into two types:
In somatic cell gene therapy (SCGT), the therapeutic genes are transferred into any cell other than a gamete, germ cell, gametocyte or undifferentiated stem cell. Any such modifications affect the individual patient only, and are not inherited by offspring. Somatic gene therapy represents mainstream basic and clinical research, in which therapeutic DNA (either integrated in the genome or as an external episome or plasmid) is used to treat disease.
Over 600 clinical trials utilizing SCGT are underway in the US. Most focus on severe genetic disorders, including immunodeficiencies, haemophilia, thalassaemia and cystic fibrosis. Such single gene disorders are good candidates for somatic cell therapy. The complete correction of a genetic disorder or the replacement of multiple genes is not yet possible. Only a few of the trials are in the advanced stages.
In germline gene therapy (GGT), germ cells (sperm or eggs) are modified by the introduction of functional genes into their genomes. Modifying a germ cell causes all the organism’s cells to contain the modified gene. The change is therefore heritable and passed on to later generations. Australia, Canada, Germany, Israel, Switzerland and the Netherlands prohibit GGT for application in human beings, for technical and ethical reasons, including insufficient knowledge about possible risks to future generations and higher risks versus SCGT. The US has no federal controls specifically addressing human genetic modification (beyond FDA regulations for therapies in general).
The delivery of DNA into cells can be accomplished by multiple methods. The two major classes are recombinant viruses (sometimes called biological nanoparticles or viral vectors) and naked DNA or DNA complexes (non-viral methods).
In order to replicate, viruses introduce their genetic material into the host cell, tricking the host’s cellular machinery into using it as blueprints for viral proteins. Scientists exploit this by substituting a virus’s genetic material with therapeutic DNA. (The term ‘DNA’ may be an oversimplification, as some viruses contain RNA, and gene therapy could take this form as well.) A number of viruses have been used for human gene therapy, including retrovirus, adenovirus, lentivirus, herpes simplex, vaccinia and adeno-associated virus. Like the genetic material (DNA or RNA) in viruses, therapeutic DNA can be designed to simply serve as a temporary blueprint that is degraded naturally or (at least theoretically) to enter the host’s genome, becoming a permanent part of the host’s DNA in infected cells.
Non-viral methods present certain advantages over viral methods, such as large scale production and low host immunogenicity. However, non-viral methods initially produced lower levels of transfection and gene expression, and thus lower therapeutic efficacy. Later technology remedied this deficiency.
Methods for non-viral gene therapy include the injection of naked DNA, electroporation, the gene gun, sonoporation, magnetofection, the use of oligonucleotides, lipoplexes, dendrimers, and inorganic nanoparticles.
Some of the unsolved problems include:
Three patients’ deaths have been reported in gene therapy trials, putting the field under close scrutiny. The first was that of Jesse Gelsinger in 1999. One X-SCID patient died of leukemia in 2003. In 2007, a rheumatoid arthritis patient died from an infection; the subsequent investigation concluded that the death was not related to gene therapy.
In 1972 Friedmann and Roblin authored a paper in Science titled “Gene therapy for human genetic disease?” Rogers (1970) was cited for proposing that exogenous good DNA be used to replace the defective DNA in those who suffer from genetic defects.
In 1984 a retrovirus vector system was designed that could efficiently insert foreign genes into mammalian chromosomes.
The first approved gene therapy clinical research in the US took place on 14 September 1990, at the National Institutes of Health (NIH), under the direction of William French Anderson. Four-year-old Ashanti DeSilva received treatment for a genetic defect that left her with ADA-SCID, a severe immune system deficiency. The effects were temporary, but successful.
Cancer gene therapy was introduced in 1992/93 (Trojan et al. 1993). The treatment of glioblastoma multiforme, the malignant brain tumor whose outcome is always fatal, was done using a vector expressing antisense IGF-I RNA (clinical trial approved by NIH n 1602, and FDA in 1994). This therapy also represents the beginning of cancer immunogene therapy, a treatment which proves to be effective due to the anti-tumor mechanism of IGF-I antisense, which is related to strong immune and apoptotic phenomena.
In 1992 Claudio Bordignon, working at the Vita-Salute San Raffaele University, performed the first gene therapy procedure using hematopoietic stem cells as vectors to deliver genes intended to correct hereditary diseases. In 2002 this work led to the publication of the first successful gene therapy treatment for adenosine deaminase-deficiency (SCID). The success of a multi-center trial for treating children with SCID (severe combined immune deficiency or “bubble boy” disease) from 2000 and 2002, was questioned when two of the ten children treated at the trial’s Paris center developed a leukemia-like condition. Clinical trials were halted temporarily in 2002, but resumed after regulatory review of the protocol in the US, the United Kingdom, France, Italy and Germany.
In 1993 Andrew Gobea was born with SCID following prenatal genetic screening. Blood was removed from his mother’s placenta and umbilical cord immediately after birth, to acquire stem cells. The allele that codes for adenosine deaminase (ADA) was obtained and inserted into a retrovirus. Retroviruses and stem cells were mixed, after which the viruses inserted the gene into the stem cell chromosomes. Stem cells containing the working ADA gene were injected into Andrew’s blood. Injections of the ADA enzyme were also given weekly. For four years T cells (white blood cells), produced by stem cells, made ADA enzymes using the ADA gene. After four years more treatment was needed.
Jesse Gelsinger’s death in 1999 impeded gene therapy research in the US. As a result, the FDA suspended several clinical trials pending the reevaluation of ethical and procedural practices.
The modified cancer gene therapy strategy of antisense IGF-I RNA (NIH n 1602) using antisense / triple helix anti IGF-I approach was registered in 2002 by Wiley gene therapy clinical trial – n 635 and 636. The approach has shown promising results in the treatment of six different malignant tumors: glioblastoma, cancers of liver, colon, prostate, uterus and ovary (Collaborative NATO Science Programme on Gene Therapy USA, France, Poland n LST 980517 conducted by J. Trojan) (Trojan et al., 2012). This antigene antisense/triple helix therapy has proven to be efficient, due to the mechanism stopping simultaneously IGF-I expression on translation and transcription levels, strengthening anti-tumor immune and apoptotic phenomena.
Sickle-cell disease can be treated in mice. The mice which have essentially the same defect that causes human cases used a viral vector to induce production of fetal hemoglobin (HbF), which normally ceases to be produced shortly after birth. In humans, the use of hydroxyurea to stimulate the production of HbF temporarily alleviates sickle cell symptoms. The researchers demonstrated this treatment to be a more permanent means to increase therapeutic HbF production.
A new gene therapy approach repaired errors in messenger RNA derived from defective genes. This technique has the potential to treat thalassaemia, cystic fibrosis and some cancers.
Researchers created liposomes 25 nanometers across that can carry therapeutic DNA through pores in the nuclear membrane.
In 2003 a research team inserted genes into the brain for the first time. They used liposomes coated in a polymer called polyethylene glycol, which, unlike viral vectors, are small enough to cross the bloodbrain barrier.
Short pieces of double-stranded RNA (short, interfering RNAs or siRNAs) are used by cells to degrade RNA of a particular sequence. If a siRNA is designed to match the RNA copied from a faulty gene, then the abnormal protein product of that gene will not be produced.
Gendicine is a cancer gene therapy that delivers the tumor suppressor gene p53 using an engineered adenovirus. In 2003, it was approved in China for the treatment of head and neck squamous cell carcinoma.
In March researchers announced the successful use of gene therapy to treat two adult patients for X-linked chronic granulomatous disease, a disease which affects myeloid cells and damages the immune system. The study is the first to show that gene therapy can treat the myeloid system.
In May a team reported a way to prevent the immune system from rejecting a newly delivered gene. Similar to organ transplantation, gene therapy has been plagued by this problem. The immune system normally recognizes the new gene as foreign and rejects the cells carrying it. The research utilized a newly uncovered network of genes regulated by molecules known as microRNAs. This natural function selectively obscured their therapeutic gene in immune system cells and protected it from discovery. Mice infected with the gene containing an immune-cell microRNA target sequence did not reject the gene.
In August scientists successfully treated metastatic melanoma in two patients using killer T cells genetically retargeted to attack the cancer cells.
In November researchers reported on the use of VRX496, a gene-based immunotherapy for the treatment of HIV that uses a lentiviral vector to deliver an antisense gene against the HIV envelope. In a phase I clinical trial, five subjects with chronic HIV infection who had failed to respond to at least two antiretroviral regimens were treated. A single intravenous infusion of autologous CD4 T cells genetically modified with VRX496 was well tolerated. All patients had stable or decreased viral load; four of the five patients had stable or increased CD4 T cell counts. All five patients had stable or increased immune response to HIV antigens and other pathogens. This was the first evaluation of a lentiviral vector administered in a US human clinical trial.
In May researchers announced the first gene therapy trial for inherited retinal disease. The first operation was carried out on a 23-year-old British male, Robert Johnson, in early 2007.
Leber’s congenital amaurosis is an inherited blinding disease caused by mutations in the RPE65 gene. The results of a small clinical trial in children were published in April. Delivery of recombinant adeno-associated virus (AAV) carrying RPE65 yielded positive results. In May two more groups reported positive results in independent clinical trials using gene therapy to treat the condition. In all three clinical trials, patients recovered functional vision without apparent side-effects.
In September researchers were able to give trichromatic vision to squirrel monkeys. In November 2009, researchers halted a fatal genetic disorder called adrenoleukodystrophy in two children using a lentivirus vector to deliver a functioning version of ABCD1, the gene that is mutated in the disorder.
An April paper reported that gene therapy addressed achromatopsia (color blindness) in dogs by targeting cone photoreceptors. Cone function and day vision were restored for at least 33 months in two young specimens. The therapy was less efficient for older dogs.
In September it was announced that an 18-year-old male patient in France with beta-thalassemia major had been successfully treated. Beta-thalassemia major is an inherited blood disease in which beta haemoglobin is missing and patients are dependent on regular lifelong blood transfusions. The technique used a lentiviral vector to transduce the human -globin gene into purified blood and marrow cells obtained from the patient in June 2007. The patient’s haemoglobin levels were stable at 9 to 10 g/dL. About a third of the hemoglobin contained the form introduced by the viral vector and blood transfusions were not needed. Further clinical trials were planned.Bone marrow transplants are the only cure for thalassemia, but 75% of patients do not find a matching donor.
Cancer immunogene therapy using modified anti gene, antisense / triple helix approach was introduced in South America in 2010/11 in La Sabana University, Bogota (Ethical Committee 14.12.2010, no P-004-10). Considering the ethical aspect of gene diagnostic and gene therapy targeting IGF-I, the IGF-I expressing tumors i.e. lung and epidermis cancers, were treated (Trojan et al. 2016). 
In 2007 and 2008, a man was cured of HIV by repeated Hematopoietic stem cell transplantation (see also Allogeneic stem cell transplantation, Allogeneic bone marrow transplantation, Allotransplantation) with double-delta-32 mutation which disables the CCR5 receptor. This cure was accepted by the medical community in 2011. It required complete ablation of existing bone marrow, which is very debilitating.
In August two of three subjects of a pilot study were confirmed to have been cured from chronic lymphocytic leukemia (CLL). The therapy used genetically modified T cells to attack cells that expressed the CD19 protein to fight the disease. In 2013, the researchers announced that 26 of 59 patients had achieved complete remission and the original patient had remained tumor-free.
Human HGF plasmid DNA therapy of cardiomyocytes is being examined as a potential treatment for coronary artery disease as well as treatment for the damage that occurs to the heart after myocardial infarction.
In 2011 Neovasculgen was registered in Russia as the first-in-class gene-therapy drug for treatment of peripheral artery disease, including critical limb ischemia; it delivers the gene encoding for VEGF. Neovasculogen is a plasmid encoding the CMV promoter and the 165 amino acid form of VEGF.
The FDA approved Phase 1 clinical trials on thalassemia major patients in the US for 10 participants in July. The study was expected to continue until 2015.
In July 2012, the European Medicines Agency recommended approval of a gene therapy treatment for the first time in either Europe or the United States. The treatment used Alipogene tiparvovec (Glybera) to compensate for lipoprotein lipase deficiency, which can cause severe pancreatitis. The recommendation was endorsed by the European Commission in November 2012 and commercial rollout began in late 2014.
In December 2012, it was reported that 10 of 13 patients with multiple myeloma were in remission “or very close to it” three months after being injected with a treatment involving genetically engineered T cells to target proteins NY-ESO-1 and LAGE-1, which exist only on cancerous myeloma cells.
In March researchers reported that three of five subjects who had acute lymphocytic leukemia (ALL) had been in remission for five months to two years after being treated with genetically modified T cells which attacked cells with CD19 genes on their surface, i.e. all B-cells, cancerous or not. The researchers believed that the patients’ immune systems would make normal T-cells and B-cells after a couple of months. They were also given bone marrow. One patient relapsed and died and one died of a blood clot unrelated to the disease.
Following encouraging Phase 1 trials, in April, researchers announced they were starting Phase 2 clinical trials (called CUPID2 and SERCA-LVAD) on 250 patients at several hospitals to combat heart disease. The therapy was designed to increase the levels of SERCA2, a protein in heart muscles, improving muscle function. The FDA granted this a Breakthrough Therapy Designation to accelerate the trial and approval process. In 2016 it was reported that no improvement was found from the CUPID 2 trial.
In July researchers reported promising results for six children with two severe hereditary diseases had been treated with a partially deactivated lentivirus to replace a faulty gene and after 732 months. Three of the children had metachromatic leukodystrophy, which causes children to lose cognitive and motor skills. The other children had Wiskott-Aldrich syndrome, which leaves them to open to infection, autoimmune diseases and cancer. Follow up trials with gene therapy on another six children with Wiskott-Aldrich syndrome were also reported as promising.
In October researchers reported that two children born with adenosine deaminase severe combined immunodeficiency disease (ADA-SCID) had been treated with genetically engineered stem cells 18 months previously and that their immune systems were showing signs of full recovery. Another three children were making progress. In 2014 a further 18 children with ADA-SCID were cured by gene therapy. ADA-SCID children have no functioning immune system and are sometimes known as “bubble children.”
Also in October researchers reported that they had treated six haemophilia sufferers in early 2011 using an adeno-associated virus. Over two years later all six were producing clotting factor.
Data from three trials on Topical cystic fibrosis transmembrane conductance regulator gene therapy were reported to not support its clinical use as a mist inhaled into the lungs to treat cystic fibrosis patients with lung infections.
In January researchers reported that six choroideremia patients had been treated with adeno-associated virus with a copy of REP1. Over a six-month to two-year period all had improved their sight. By 2016, 32 patients had been treated with positive results and researchers were hopeful the treatment would be long-lasting. Choroideremia is an inherited genetic eye disease with no approved treatment, leading to loss of sight.
In March researchers reported that 12 HIV patients had been treated since 2009 in a trial with a genetically engineered virus with a rare mutation (CCR5 deficiency) known to protect against HIV with promising results.
Clinical trials of gene therapy for sickle cell disease were started in 2014 although one review failed to find any such trials.
In February LentiGlobin BB305, a gene therapy treatment undergoing clinical trials for treatment of beta thalassemia gained FDA “breakthrough” status after several patients were able to forgo the frequent blood transfusions usually required to treat the disease.
In March researchers delivered a recombinant gene encoding a broadly neutralizing antibody into monkeys infected with simian HIV; the monkeys’ cells produced the antibody, which cleared them of HIV. The technique is named immunoprophylaxis by gene transfer (IGT). Animal tests for antibodies to ebola, malaria, influenza and hepatitis are underway.
In March scientists, including an inventor of CRISPR, urged a worldwide moratorium on germline gene therapy, writing scientists should avoid even attempting, in lax jurisdictions, germline genome modification for clinical application in humans until the full implications are discussed among scientific and governmental organizations.
Also in 2015 Glybera was approved for the German market.
In October, researchers announced that they had treated a baby girl, Layla Richards, with an experimental treatment using donor T-cells genetically engineered to attack cancer cells. Two months after the treatment she was still free of her cancer (a highly aggressive form of acute lymphoblastic leukaemia [ALL]). Children with highly aggressive ALL normally have a very poor prognosis and Layla’s disease had been regarded as terminal before the treatment.
In December, scientists of major world academies called for a moratorium on inheritable human genome edits, including those related to CRISPR-Cas9 technologies but that basic research including embryo gene editing should continue.
In April the Committee for Medicinal Products for Human Use of the European Medicines Agency endorsed a gene therapy treatment called Strimvelis and recommended it be approved. This treats children born with ADA-SCID and who have no functioning immune system – sometimes called the “bubble baby” disease. This would be the second gene therapy treatment to be approved in Europe.
Speculated uses for gene therapy include:
Gene Therapy techniques have the potential to provide alternative treatments for those with infertility. Recently, successful experimentation on mice has proven that fertility can be restored by using the gene therapy method, CRISPR. Spermatogenical stem cells from another organism were transplanted into the testes of an infertile male mouse. The stem cells re-established spermatogenesis and fertility.
Athletes might adopt gene therapy technologies to improve their performance.Gene doping is not known to occur, but multiple gene therapies may have such effects. Kayser et al. argue that gene doping could level the playing field if all athletes receive equal access. Critics claim that any therapeutic intervention for non-therapeutic/enhancement purposes compromises the ethical foundations of medicine and sports.
Genetic engineering could be used to change physical appearance, metabolism, and even improve physical capabilities and mental faculties such as memory and intelligence. Ethical claims about germline engineering include beliefs that every fetus has a right to remain genetically unmodified, that parents hold the right to genetically modify their offspring, and that every child has the right to be born free of preventable diseases. For adults, genetic engineering could be seen as another enhancement technique to add to diet, exercise, education, cosmetics and plastic surgery. Another theorist claims that moral concerns limit but do not prohibit germline engineering.
Possible regulatory schemes include a complete ban, provision to everyone, or professional self-regulation. The American Medical Associations Council on Ethical and Judicial Affairs stated that “genetic interventions to enhance traits should be considered permissible only in severely restricted situations: (1) clear and meaningful benefits to the fetus or child; (2) no trade-off with other characteristics or traits; and (3) equal access to the genetic technology, irrespective of income or other socioeconomic characteristics.”
As early in the history of biotechnology as 1990, there have been scientists opposed to attempts to modify the human germline using these new tools, and such concerns have continued as technology progressed. With the advent of new techniques like CRISPR, in March 2015 a group of scientists urged a worldwide moratorium on clinical use of gene editing technologies to edit the human genome in a way that can be inherited. In April 2015, researchers sparked controversy when they reported results of basic research to edit the DNA of non-viable human embryos using CRISPR.
Regulations covering genetic modification are part of general guidelines about human-involved biomedical research.
The Helsinki Declaration (Ethical Principles for Medical Research Involving Human Subjects) was amended by the World Medical Association’s General Assembly in 2008. This document provides principles physicians and researchers must consider when involving humans as research subjects. The Statement on Gene Therapy Research initiated by the Human Genome Organization (HUGO) in 2001 provides a legal baseline for all countries. HUGOs document emphasizes human freedom and adherence to human rights, and offers recommendations for somatic gene therapy, including the importance of recognizing public concerns about such research.
No federal legislation lays out protocols or restrictions about human genetic engineering. This subject is governed by overlapping regulations from local and federal agencies, including the Department of Health and Human Services, the FDA and NIH’s Recombinant DNA Advisory Committee. Researchers seeking federal funds for an investigational new drug application, (commonly the case for somatic human genetic engineering), must obey international and federal guidelines for the protection of human subjects.
NIH serves as the main gene therapy regulator for federally funded research. Privately funded research is advised to follow these regulations. NIH provides funding for research that develops or enhances genetic engineering techniques and to evaluate the ethics and quality in current research. The NIH maintains a mandatory registry of human genetic engineering research protocols that includes all federally funded projects.
An NIH advisory committee published a set of guidelines on gene manipulation. The guidelines discuss lab safety as well as human test subjects and various experimental types that involve genetic changes. Several sections specifically pertain to human genetic engineering, including Section III-C-1. This section describes required review processes and other aspects when seeking approval to begin clinical research involving genetic transfer into a human patient. The protocol for a gene therapy clinical trial must be approved by the NIH’s Recombinant DNA Advisory Committee prior to any clinical trial beginning; this is different from any other kind of clinical trial.
As with other kinds of drugs, the FDA regulates the quality and safety of gene therapy products and supervises how these products are used clinically. Therapeutic alteration of the human genome falls under the same regulatory requirements as any other medical treatment. Research involving human subjects, such as clinical trials, must be reviewed and approved by the FDA and an Institutional Review Board.
Gene therapy is the basis for the plotline of the film I Am Legend and the TV show Will Gene Therapy Change the Human Race?.
Gene therapy – Wikipedia
Posted: at 7:35 am
This article is about the one-way manned trip to Mars proposed for 2026. For the first Soviet spacecraft for Mars, see Mars 1. For other uses, see Mars 1 (disambiguation).
Mars One is an organization based in the Netherlands that has proposed to land the first humans on Mars and establish a permanent human colony there by 2026. The private spaceflight project is led by Dutch entrepreneur Bas Lansdorp, who announced the Mars One project in May 2012. The project’s schedule, technical and financial feasibility, and ethics, have been criticized by scientists, engineers and those in the aerospace industry.
Mars One’s original concept included launching a robotic lander and orbiter as early as 2016 to be followed by a human crew of four in 2022. Organizers plan for the crew to be selected from applicants who paid an administrative fee, to become the first permanent residents of Mars with no plan of returning to Earth. Partial funding options, which have yet to be realized, include a proposed reality television program documenting the journey. In February 2015, the primary contractors on the initial pre-Phase A contracts had completed all studies paid for by Mars One at that time. The current state of the Mission Plan Deliverables (either in the form of Studies or actual Hardware) will be tracked in Table 2 in the Technology section.
The Mars One organization is the controlling stockholder of the for-profit Interplanetary Media Group.
The concept for Mars One began in 2011 with discussions between the two founders, Bas Lansdorp and Arno Wielders.
The Mars One project has no connection with Inspiration Mars, a similarly-timed project to send a married couple on a Mars flyby and return them to Earth over a period of 500 days.
Mars One publicly announced the concept in May 2012 for a one-way trip to Mars, with the intention of an initial robotic precursor mission in 2020 and transporting the first human colonists to Mars in 2024. In a 2015 debate, Bas Lansdrop clarified that “were not going to do, I think, the current design of the mission” and “Mars One’s goal is not to send humans to Mars in 2027 with a $6 billion budget and 14 launches. Our goal is to send humans to Mars, period.” According to Mars One’s website, “It is Mars One’s goal to establish a permanent human settlement on Mars.”
In December 2013, Mars One announced its concept of a robotic precursor mission in 2018, two years later than had been conceptually planned in the 2012 announcements. The robotic lander would be “built by Lockheed Martin based on the design used for NASA’s Phoenix and InSight missions, as well as a communications orbiter built by Surrey Satellite Technology Ltd.” In February 2015, Lockheed Martin and Surrey Satellite Technology confirmed that contracts on the initial study phase begun in late 2013 had run out and additional contracts had not been received for further progress on the robotic missions. Plans have been disclosed to raise the US$200 million or more needed to support the initial robotic mission, but some critics do not find the economic plans to raise money from private investors and exclusive broadcasting rights to be sufficient to support the initial, or follow-on, mission(s).
Mars One selected a second-round pool of astronaut candidates in 2013 of 1058 people”586 men and 472 women from 107 countries”from a larger number of 202,586 who initially showed interest on the Mars One website, although this number is heavily disputed. Former Mars One candidate Dr. Joseph Roche claims the number of initial applicants was only 2,761, which Mars One later conceded via YouTube video.
Mars One announced a partnership with Uwingu on 3 March 2014, stating that the program would use Uwingu’s map of Mars in all of their planned missions.Kristian von Bengtson began work on Simulation Mars Home for crew on 24 March 2014.
The second-round pool was whittled down to 705 candidates (418 men and 287 women) in the beginning of May 2014. 353 were removed due to personal considerations. After the medical physical requirement, which was similar to a normal FAA exam plus EKG, due either to financial, health or access reasons, only 660 candidates remained. Notably, some applicants were notified of life-threatening conditions such as early-stage cancer and were able to immediately begin treatment. These selected persons will then begin the interview process following which several teams of two men and two women will be compiled. The teams will then begin training full-time for a potential future mission to Mars, while individuals and teams may be selected out during training if they are not deemed suitable for the mission.
On June 2, 2014, Darlow Smithson Productions (DSP) announced it has gained exclusive access to Mars One.
On June 30, 2014, it was made public that Mars One seeks financial investment through a bidding process to send company experiments to Mars. The experiment slots will go to the highest bidder and will include company-related ads, and the opportunity to have the company name on the robotic lander that is proposed to carry the experiments to Mars in 2018.
Mars One selected a third-round pool of astronaut candidates in 2015 of 100 people “50 men and 50 women who successfully passed the second round. The candidates come from all around the world, namely 39 from the Americas, 31 from Europe, 16 from Asia, 7 from Africa, and 7 from Oceania”.
In a video posted on 19 of March 2015, Lansdorp said that because of delays in the robotic precursor mission, the first crew will not set down on Mars until 2027. In August 2015, Lansdorp reiterated that their 12-year plan for landing humans on Mars by 2027 is subject to constant improvement and updates.
The Space Review reported in October 2016 that while Mars One was “successful in generating a tremendous amount of publicity as well as enormous excitement about Mars, … its proposal lacked substance both in mission architecture and in workable funding mechanisms. As such, it has faded from the public consciousness.”
According to their schedule as of March 2015, the first crew of four astronauts would arrive on Mars in 2027, after a seven-month journey from Earth. Additional teams would join the settlement every two years, with the intention that by 2035 there would be over twenty people living and working on Mars. The astronaut selection process began on 22 April 2013.
As of July 2015[update], the fourth round astronaut selection process, planned for Sept 2016, by which Mars One will choose six teams of four out of the 100 people selected in the third round, was announced.
In December 2013, mission concept studies for an unmanned Mars mission were contracted with Lockheed Martin and Surrey Satellite Technology for a demonstration mission to be launched in 2017 and land on Mars in 2018. It would be based on the design of the successful 2007 NASA Phoenix lander, and provide proof of concept for a subset of the key technologies for a later permanent human settlement on Mars. Upon submission of Lockheed Martin’s Proposal Information Package, Mars One released a Request for Proposals for the various payloads on the lander. The total payload mass of 44kg is divided among the seven payloads as follows:
In 2022, an unmanned rover will be launched to Mars in order to pick a landing site for the 2027 Mars One landing and a site for the Mars One colony. At the same time, a communication satellite will be launched, enabling continuous communication with the Mars One colony.
In 2024, the 6 cargo missions will be launched in close succession, consisting of two living units, two life-support units, and two supply units.
A spacecraft containing four astronauts will be launched from Earth to meet a Transit vehicle bound for Mars.
In 2027, the landing module will land on Mars, containing four astronauts. They will be met by the rover launched in 2020, and taken to the Mars One colony.
The application was available from 22 April 2013 to 31 August 2013. This first application consists of applicants general information, a motivational letter, a rsum and a video. More than 200,000 people expressed interest, so Mars One plans to hold several other application periods in the future.
By 9 September 2013, 4,227 applicants had paid their registration fee and submitted public videos in which they made their case for going to Mars in 2023. The application fee varies from US $5 to US $75 (the amount depending on the relative wealth of the applicant’s country).
Distribution of the 1,058 applicants selected for Round 2 according to the academic degree
The results of applicants selected for round 2 were declared on 30 December 2013. A total of 1,058 applicants from 107 countries were selected. The gender split is 586 male (55.4%) and 472 female (44.6%). Among the people that were selected for round 2, 159 have a master’s degree, 347 have bachelor’s degrees and 29 have Doctor of Medicine (M.D.) degrees. The majority of the applicants are under 36 and well educated.
Medically cleared candidates were interviewed, and 50 men and 50 women from the total pool of 660 from around the world were selected to move on to the third round of the astronaut selection process:
Although initial plans were for the Mars One selection committee to perform regional interviews around the world, applicants were ultimately remotely interviewed and recorded by Mars One over a relatively short Skype/SparkHire call regarding Martian-related orbital, temp/pressure, geological and historical parameters and the specific elements of the Mars One one-way mission. Dr. Joseph Roche, one of the finalists, has accused the selection process of being based on a point system that is primarily dependent on how much money each individual generated or gave to the Mars One organization, despite many of the round three selectees having not spent any money in the process, apart from the application fee, which varied as a function of each applicant’s country GDP. Lansdorp acknowledges a “gamification” point system but denies that selection is based on money earned. Roche also stated that if paid for interviews, they are asked to donate 75% of the payment to Mars One. This was confirmed by Lansdorp.
It was originally planned that the pool of roughly one thousand successful applicants would be narrowed through regional contests. These events did not take place, and the above-mentioned group of 100 candidates were selected through the remote interview process and selected directly to round 3 in February 2015.
In late 2013, details of the 2015 selection phases had not been agreed upon due to ongoing negotiations with media companies for the rights to televise the selection processes.[needs update]
It was planned that the regional selection may be broadcast on TV and Internet in countries around the world. In each region, plans included 2040 applicants participating in challenges including rigorous simulations, many in team settings, with focus on testing the physical and emotional capabilities of the remaining candidates, with the aim of demonstrating their suitability to become the first humans on Mars. The audience was to select one winner per region, and the experts could select additional participants, if needed, to continue to the international level.[needs update]
Round three takes place in 2016[needs update], over the course of 5 days. At the start of the event, the candidates organize themselves into groups of 105 men and 5 women of diverse nationalities and age groups.
The Mars One selection committee then sets up group dynamic challenges and provide study materials related to each challenge. This allow them to observe how the candidates work in a group setting and choose candidates for elimination.[needs update]
At the end of each day all the teams except the winner lose members; then they reorganize themselves for the following day. At the end 40 candidates remain.
The remaining 40 candidates are spending nine days in an isolation unit. The candidates are observed closely to examine how they act in situations of prolonged close contact with one another. This test is implemented because, during the journey to Mars and upon arrival, the candidates will spend 24 hours a day with each other and during this time the simplest things may start to become bothersome. It takes a specific team dynamic to be able to handle this, and the goal of this selection round is to find those that are best suited for this challenge.
After the isolation round, 30 candidates are chosen to partake in a Mars Settler Suitability Interview.
The Mars Settler Suitability Interview measures suitability for long duration Space missions and Mars settlement and will last approximately 4 hours. 24 candidates are selected after the interview and will be offered full-time employment with Mars One.
From the previous selection series, six groups of four are to become full-time employees of the Mars One astronaut corps, after which they are to train for the mission. Whole teams and individuals might be deselected during training if they prove not to be suitable for the mission. Six to ten teams of four people are to be selected for seven years of full-time training.
Mars One funding comes from private investment (undisclosed), intellectual property (IP) rights, the sale of future broadcasting rights, and astronaut application fees.
Mars One’s investment of revenues
Concept design studies (78.3%)
Travel expenses (11.6%)
Legal expenses (3.3%)
Website maintenance (2.4%)
Office and other (2.1%)
On January 29, 2013, Mars One announced its initial batch of investors from the Netherlands and South Africa. The value of the investment remains undisclosed.
Mars One initially estimated a one-way trip, excluding the cost of maintaining four astronauts on Mars until they die, at 6 billion USD. Lansdorp has declined questions regarding the cost estimate because he believes “it would be very stupid for us to give the prices that have been quoted per component”. For comparison, an “austere” manned Mars mission (including a temporary stay followed by a return of the astronauts) proposed by NASA in 2009 had a projected cost of $100 billion USD after an 18-year program, including a NASA-required return component.
Mars One, the not-for-profit foundation, is the controlling stockholder of the for-profit Interplanetary Media Group. A proposed global “reality-TV” media event was intended to provide funds to finance the expedition, however, no such reality TV show has emerged and no contracts have been signed. The astronaut selection process (with some public participation) was to be televised and continue on through the first years of living on Mars.
Discussions between Endemol, producers of the Big Brother series, and Mars One ended with Endemol subsidiary Darlow Smithson Productions issuing a statement in February 2015 that they “were unable to reach agreement on the details of the contract” and that the company was “no longer involved in the project.” Lansdorp updated plans to no longer include live broadcasts from Mars but instead rely on a documentary-style production, adding “Just like the Olympics, we watch highlights, we don’t watch things that athletes do when they’re not performing their abilities.”
On 31 August 2012, company officials announced that funding from its first sponsors had been received. Corporate sponsorship money will be used mostly to fund the conceptual design studies provided by the aerospace suppliers.
Since the official announcement of their conversion to a Stichting, Mars One has been accepting one-time and regular monthly donations through their website. As of 4 July 2016, Mars One had received $928,888 in donations and merchandise sales. The recent donation update adds the Indiegogo campaign ($313,744) to the private donation and merchandise total.
Over three quarters of the investment is in concept design studies. Mars One states that “income from donations and merchandise have not been used to pay salaries”. To date, no financial records have been released for public viewing.
On 10 December 2013, Mars One set up a crowdfunding campaign on Indiegogo to fund their 2018 demonstration mission. The 2018 mission includes a lander and communications satellite, and aims to prove several mission critical technologies in addition to launch and landing. The campaign goal was to raise $400,000 USD by 25 January 2014. Since the ending date was drawing near, they decided to extend the ending date to 9 February 2014. By the end of the campaign, they had received $313,744 in funds. Indiegogo will receive 9% ($28,237) of the $313,744 for the campaign failing to achieve its goal.
Mars One has identified at least one potential supplier for each component of the mission. The major components are planned to be acquired from proven suppliers. As of May 2013[update], Mars One has a contract with only one company, Paragon Space Development Corporation, for a preliminary life support study.
The Falcon Heavy from SpaceX was the notional launcher in the early Mars One conceptual plan, which included the notional use of SpaceX hardware for the lander and crew habitat, but, as of May 2013, SpaceX had not yet been contracted to supply mission hardware, and SpaceX has stated that it did “not currently have a relationship with Mars One.” By March 2014, SpaceX indicated that they had been contacted by Mars One, and were in discussions, but that accommodating Mars One requirements would require some additional work and that such work was not a part of the current focus of SpaceX.
A manned interplanetary spacecraft, which would transport the crew to Mars, would be assembled in low Earth orbit and comprise two propellant modules: a Transit Living Module (discarded just before arrival at Mars) and a lander (see “Human Lander” below).
A potential supplier for the Transit living module as of November 2012[update] was Thales Alenia Space.[non-primary source needed]
Contract has been signed with Lockheed Martin to build the Demo Lander with the same designs as the Phoenix lander that went to Mars.
In December 2013 Mars One awarded a contract to Surrey Satellite Technology for a study of the satellite technology required to provide 24/7 communication between Earth and the Mars base. Mars One proposed at least two satellites, one in areostationary orbit above Mars and a second at the Earth Sun L4 or L5 point to relay the signal when Mars blocks the areosynchronous satellite from line of sight to Earth. It is possible that a third satellite will be required to relay the signal on the rare occasions when the Sun blocks the first relay satellite from line of sight with Earth.
An early notional Mars One lander was shown in concept art as a 5 meters (16ft)-diameter variant of SpaceX’s Dragon capsule. SpaceX has not agreed for their technoogy to be used by the Mars One project.
The rover would be unpressurized and support travel distances of 80km (50 miles). A potential supplier for the rover as of November 2012[update] was Astrobotic Technology.[non-primary source needed]
The Mars suit would be flexible to allow the settlers to work with both cumbersome construction materials and sophisticated machinery when they are outside the habitat while protecting them from the cold, low pressure and noxious gases of the Martian atmosphere. The likely supplier of the suits is ILC Dover. On 12 March 2013, Paragon Space Development Corporation was contracted to develop concepts for life support and the Mars Surface Exploration Spacesuit System. The Paragon Space Development Corporation study was stated to be finished late summer 2013; Mars One released the results of this (ECLSS portion only) study to the public in June 2015. The Mars suit study portion of the original contract has just entered ITAR review, with a publicly accessible copy available once passed through review.
Mars One has received a variety of criticism, mostly relating to medical, technical and financial feasibility. There are also unverified claims that Mars One is a scam designed to take as much money as possible from donors, including reality show contestants. Many have criticized the project’s US$6 billion budget as being too low to successfully transport humans to Mars, to the point of being delusional. A similar project study by NASA estimated the cost of such a feat at US$100 billion, although that included transporting the astronauts back to Earth. Objections have also been raised regarding the reality TV project associated with the expedition. Given the transient nature of most reality TV ventures, many believe that as viewership declines, funding could significantly decrease, thereby harming the entire expedition. Further, TV reality show contestants have reported that they were ranked based on their donations and funds raised.
John Logsdon, a space policy expert at George Washington University, criticized the program, saying it appears to be a scam and not “a credible proposition”.
Chris Welch, director of Masters Programs at the International Space University, has said “Even ignoring the potential mismatch between the project income and its costs and questions about its longer-term viability, the Mars One proposal does not demonstrate a sufficiently deep understanding of the problems to give real confidence that the project would be able to meet its very ambitious schedule.”
Gerard ‘t Hooft, theoretical physicist and ambassador to Mars One, has stated that he thought both their proposed schedule and budget were off by a factor of ten. He said he still supported the project’s overall goals.
A space logistics analysis conducted by PhD candidates at the Massachusetts Institute of Technology revealed that the most optimistic of scenarios would require 15 Falcon Heavy launches that would cost approximately $4.5 billion. They concluded that the reliability of Environmental Control and Life Support systems (ECLS), the Technology Readiness Levels (TRL), and in situ resource utilization (ISRU) would have to be improved. Additionally, they determined that if the costs of launch were also lowered dramatically, together this would help to reduce the mass and cost of Mars settlement architecture. The environmental system would result in failure to be able to support human life in 68 days if fire safety standards on over-oxygenation were followed, due to excessive use of nitrogen supplies that would not then be able to be used to compensate leakage of air out of the habitat, leading to a resultant loss in pressurization, ending with pressures too low to support human life. Lansdorp replied that although he has not read all the research, supplier Lockheed Martin says that the technologies were viable.
Another serious concern uncovered in the research conducted by MIT is replacement parts. The PhD candidates estimated the need for spare parts in a Mars colony based on the failure rates of parts on the ISS. They determined that a resupply mission every two years would be necessary unless a large space in the initial launch were to be reserved for extra materials. Lansdorp commented on this saying, “They are correct. The major challenge of Mars One is keeping everything up and running. We don’t believe what we have designed is the best solution. It’s a good solution.”
In March 2015, one of the Mars One finalists, Joseph Roche, stated to media outlets that he believes the mission to be a scam. Roche holds doctorate degrees in physics and astrophysics, and shared many of his concerns and criticisms of the mission. These claims include that the organization lied about the number of applicants, stating that 200,000 individuals applied versus Roche’s claim of 2,761, and that many of the applicants had paid to be put on the list. Furthermore, Roche claimed that Mars One is asking finalists for donations from any money earned from guest appearances (which would amount to a minimal portion of the estimated $6 billion required for the mission). Finally, despite being one of 100 finalists, Roche himself has never spoken to any Mars One employee or representative in person, and instead of psychological or psychometric testing as is normal for astronaut candidates (especially for a lengthy, one-way mission), his interview process consisted of a 10-minute Skype conversation.
Robert Zubrin, advocate for manned Martian exploration, said “I don’t think the business plan closes it. We’re going to go to Mars, we need a billion dollars, and we’re going to make up the revenue with advertising and media rights and so on. You might be able to make up some of the money that way, but I don’t think that anyone who is interested in making money is going to invest on that basis invest in this really risky proposition, and if you’re lucky you’ll break even? That doesn’t fly.” Despite his criticisms, Zubrin became an adviser to Mars One on 10 October 2013.
Canadian former astronaut Julie Payette said during the opening speech for an International Civil Aviation Organization conference that she does not think Mars One “is sending anybody anywhere”.
In January 2014, German former astronaut Ulrich Walter strongly criticized the project for ethical reasons. Speaking with Tagesspiegel, he estimated the probability of reaching Mars alive at only 30%, and that of surviving there more than three months at less than 20%. He said, “They make their money with that [TV] show. They don’t care what happens to those people in space… If my tax money were used for such a mission, I would organize a protest.”
Space tourist Richard Garriott stated in response to Mars One, “Many have interesting viable starting plans. Few raise the money to be able to pull it off.”
Former astronaut Buzz Aldrin said in an interview that he wants to see humans on Mars by 2035, but he does not think Mars One will be the first to achieve it.
Wired magazine gave it a plausibility score of 2 out of 10 as part of their 2012 Most Audacious Private Space Exploration Plans.
The Daily Mail enumerated reasons why the project will never happen, calling the project “foolish”. The project lacks current funding as well as sources for future funding. The organization has no spacecraft or rocket in development or any contracts in place with companies that could provide a spacecraft or rocket. While plans point to SpaceX for both resources, the company has no contracts with Mars One in an industry that typically plans contracts decades in advance. The organization has not shared any research into the effects of microgravity on crews in flight or reduced gravity on the Mars surface. The organization has yet to provide plans or even study how crews might survive dust storms, supply challenges or the increased radiation on Mars.
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Mars One – Wikipedia